Personal hygiene and physical training for women

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BOOKS

BY

ANNA M. GALBRAITH, M.D.

Four Epochs of Woman's Life
i2mo of 260 pages.

3d Edition, Ready Soon

Personal Hygiene and Physical
Training for Women

i2mo of 393 pages, illustrated

2d Edition

G .

PERSONAL HYGIENE

AND

PHYSICAL TRAINING
FOR WOMEN " "' v

BY

ANNA M. GALBRAITH, M.D.

Author of " Hygiene and Physical Culture for Women " and " The Four
Epochs of Woman's Life ; " Member of the New York County and State and
the American Medical Associations ; Fellow of the New York Academy of
Medicine; Ex-President of the Alumnae Association, Woman's Medical College
of Pennsylvania ; former Attending Physician, Neurological Department, of
the New York Orthopoedic Hospital and Dispensary; late Attending Physician
and Instructor in Diagnosis and Clinical Medicine at the Woman's Medical
College, New York Infirmary

SECOND EDITION. THOROUGHLY REVISED

«

PHILADELPHIA AND LONDON

B. SAUNDERS COMPANY

1916

Copyright, 191 1, by W. B. Saunders Company. Reprinted

April 1913, and October, 1915. Revised,

reprinted, and recopyrighted

November, 1916

Copyright, 1916, by W. B. Saunders Company

PRINTED IN AMERICA

PRESS OF

W. B. SAUNDERS COMPANY
PHILADELPHIA

In Loving Memory

of
HELEN WORTHING WEBSTER, M.D.

Professor of Physiology and Hygiene and Resident Physician at Vassar College
from 1874 to 1881

An untiring worker of charming and inspiring personality
the living embodiment of all that was womanly,

great hearted, and noble

This book Is affectionately dedicated as a slight tribute of
the esteem in which she was held, and in grateful acknowl-
edgment of the value of her teachings
By her former pupil

AUTHOR

PREFACE TO THE SECOND EDITION

SINCE the writing of this book six years ago the entire
subject of digestion has been revised by scientific research,
and thanks to the same scientists the nutritive value of
the various food-stuffs has been ascertained. The im-
portance of this knowledge is so great that educators
are now making an endeavor to have the nutritive value
of artificial and canned goods placed on their labels; and
the New York Board of Health has requested a large
Chain of Restaurants to J&ve the nutritive value of
foods printed, beside the cost of the various articles, on
their bill of fare.

Hence the entire chapter on Digestion and Nutrition
has been rewritten. In Chapter I has been given the
result of original statistical studies, showing the urgent
need for every woman to know and put into practice the
principles of personal hygiene.

Dancing has become such a popular form of exercise
that a description of the plates giving the dancing steps
has been added, together with some simple dancing ex-
ercises. For these excellent descriptions the author t is
indebted to Miss Barbara Blankenhorn, a widely known
teacher of music and dancing of Englewood, New Jersey.

The reason that such a comparatively short space was
given in this work to "pelvic physiology and hygiene"
was that this subject had been treated in extenso, in
"The Four Epochs of Woman's Life."

ANNA M. GALBRAITH.

NEW YORK CITY,
November, 1916.

PREFACE

THE aim of this work has been to present in a clear
and concise manner the fundamental physiological laws
on which all personal hygiene is based ; together with the
practical, detailed directions for the proper development
of the body and the training of the physical powers to
their highest degree of efficiency bv. means of fresh air,
tonic baths, proper food and clothing, gymnastic and out-
door exercise, so that the tissues will be placed in the
best possible condition to resist disease.

The spirit of the tunes demands nothing less than the
most perfect development of body and mind of which
youth is capable, and maintaining the highest degree of
efficiency of the adult worker for the longest possible term
of years. The fiat has gone forth from the American
Medical Association for the scientific education of the
public in the laws of hygiene and sanitation. And the
great civic movement inaugurated by that same Associa-
tion and the Committee of One Hundred on National
Health for the establishment of a National Department
of Public Health, promises to be crowned with success in
the near future. And so it has been deemed superfluous
to expound at length what preventive medicine has al-
ready accomplished in the short space of fifty years by
the eradication of terrible epidemics and many diseases,

5

6 PREFACE

and what a general knowledge of applied hygiene might
reasonably be expected to accomplish in the near future.
It gives the author great pleasure to have this oppor-
tunity of expressing her deep indebtedness to Miss Ruth
Blankenhorn, Vassar College, A. B., 1909, of Englewood,
N. J., a most artistic and graceful dancer who posed for
all the illustrations; and to Miss Harriet I. Ballintine, the
able director of the Vassar College Gymnasium, who ar-
ranged the poses for the very excellent plates illustrating
the free exercises and classic dances. Also to the Vassar
College Athletic Association for 1908-09 for the especially
arranged dances and field sports which they were so ex-
tremely kind as to demonstrate for her benefit.

ANNA M. GALBRAITH.
NEW YORK CITY.

CONTENTS

CHAPTER I

PAOB

THE WISDOM OF PHYSICAL EFFICIENCY ..................... 11

Physical Efficiency as an Exact Science; Marks for Phys-
ical Efficiency; Statistical Study of the Physical Examina-
tions of 160 Young Women; the Physical Status of the
Women of Today; the Reflex Action of the Various Impair-
ments of the Entire Organism.

CHAPTER II
HYDRO-THERAPY .......................................... 23

Description of the Skin; Functions of the Skin; the Phys-
iologic Effects of Water, Hot and Cold; the Chief Varieties
of Baths; Ablutions; the Tub Bath; the Alcohol Rub; the
Cold Dip; Alkaline and Saline Baths; the Rain Douche or
Shower Bath; the Hot Foot-bath; the Sitz Bath; Salt Ablu-
tion; the Turkish Bath; the Electric-light Bath' Indica-
tions for the Use of Turkish Bath, and Contraindications;
the Douche; Rationale of the Douche; Contraindications.

The Internal Use of Water; Its Action on the Heart and
Blood, on the Digestion; Therapeutic Indications for the
Use of Water; Contraindications for Drinking Cold Water.

Enemas; Vaginal Douche; Douching the Ear.

CHAPTER III

THE CARE OF THE SKIN AND ITS APPENDAGES ............... 57

The Complexion; the Action of the Bath in Health; the
Proper Time to Bathe; the Care of Wash-cloths; Cleansing
the Face; Protection of the Face; the Use of So-called Cos-
metics for the Face; Facial Blemishes, Freckles, Liver Spots,
Sallow Complexion, Pimples; Acne, Eczema, Wrinkles and
Their Treatment; the Relation of Diseases of the Skin to
Internal Disorders.

The Hair; Dandruff ; Causes and Treatment of Premature
Thinness of the Hair and Baldness; the Care of the Hair;
Gray Han*.

The Cosmetic Care and Treatment of the Hands; Cos-
metic of the Nails; the Care of the Feet; Painful Affections
of the Feet.

O CONTENTS

CHAPTER IV

PAGB

THE DIGESTIVE SYSTEM: GENERAL PRINCIPLES IN HUMAN
NUTRITION AND DIETETICS 80

The Digestive Tract; Care of the Mouth and Teeth;
Controlling Factors of Digestion; Psychic Aspect of Diges-
tion; Importance of Mechanical Factors; Chemical Changes
of Food in the Stomach; Intestinal Digestion; Metabolism;
Constipation and Its Treatment.

The Amount of Food Required; the Classification of
Foods; Standard Dietaries; Maintenance Diet; Relations
of Diet to Various Conditions of Life; Practical Facts for
Guidance; Dietary in the Tropics; Food Economics; Table
of Food Values.

The Physiologic Action of Moderate Doses of Alcohol;
the Effect of Alcohol on the Muscular System; the Effect of
Alcohol on the Nervous System.

CHAPTER V

THE RESPIRATORY AND CIRCULATORY SYSTEMS: THE KIDNEYS. . 137

The Mechanics of Circulation and Respiration; the Cir-
culatory Apparatus; the Lungs; Hygiene of the Lungs
and Its Relation to the General Health; Relation of Res-
piration to Body Heat; the Respiratory Functions of the
Abdominal Muscles; the Importance of Good Chest Devel-
opment, Proper Relation Between the Height, Weight, and
Chest Measurements; Chemical Properties of Air; Town
and Country Air; Dust and Its Relations to Disease; R61e
Played by Bacteria; Ventilation; the Injurious Effects of
Overheated Air; the Proper Degree of Moisture for the
Air of the House; Ventilation of Bed-rooms.

Care of the Nose, Throat, and Ears; Impediments to ,
Respiration; Ventilation of the Lungs and Breathing Ex-
ercises; Cure of Chronic Bronchitis by Deep Breathing Ex-
ercises; Relation of Colds to Pneumonia and Tuberculosis,
and Their Prevention.

The Kidneys and Their Functions; the Physiology of
the Female Pelvic Organs.

CHAPTER VI

THE NERVOUS SYSTEM AS THE BALANCE OF POWER IN THE
BODY 184

The Brain the Master Organ of the Body; the Functions '
of the Brain; Habit and Automatism; the Ph}rsiology of the
Brain and Nervous System; the Hygiene of Work; the Tox-
ins of Fatigue; Overwork; Signs of Overwork; Nature's Res-
toratives; Avocation; the Physiologic Necessity for Laugh-
ter; Vacations and Health; Sleep; Insomnia.

The Eyes; Eye-strain; Description of the Visual Appa-
ratus; Optical Defects and Their Correction; the Mechan-

CONTENTS 9

PAOB

ism of Eye-strain; Locai Symptoms of Eye^strain; Arti-
ficial Lighting; Hygienic Precautions in Reading and Sew-
ing; Injuries to the Eyes; Symptoms and Treatment of
Conjunctivitis; Trachoma; Styes.

Functional Nervous Disorders; Headache; Neurasthenia.

CHAPTER VII

THE HYGIENE OF THE MIND AND ITS RELATION TO THE PHYSICAL
HEALTH 224

Heredity: Temperament; Social Instincts; Fear.

Mental Development; Self-control, the Moral Sense, the
Religious Instincts; the Advantages of College Life; Bal-
ance of the Mental Faculties; the Effects of th£ Higher Ed-
ucation of Women. »>

The Environment; the Choice of Friends; Literature.

The Power of the Will or Inhibition; the Effect of the
Mental Attitude on the Physical Health; A Definite Occu-
pation a Physical Necessity; the Psychology of Success.

CHAPTER VIII

DRESS THE FUNDAMENTAL CAUBE OF WOMAN'S PHYSICAL

DETERIORATION 252

The History of Woman's Dress; the Corset in History;
the Crusade Against the Corset; the Influence of the Corset
on the Female Body ; the Curved Front Corset; the Relation
of Corsets to Abdominal and Pelvic Disorders; the Effects
of Corsets on the Muscles; the Straight Front Corset; the
Abdominal Corset; the Wearing of Corsets by Young Girls;
What Style of Corset is the Least Injurious; the Shoe; the
Stockings; the Essential Qualities for Winter Underclothing;
the Length of the Walking Skirt; the Winter Street Dress.

CHAPTER IX

PHYSICAL TRAINING THE KEY TO HEALTH AND BEAUTY 283

The Ancient Greeks the Most Perfect Type of Beauty;
the Cause of the Inferior Physique of American Women; the
Physical Training of the Japanese Women; Improved
Physique as the Result of Physical Training; Increasing
Stature and Improved Physique of American Men: Report
of the Royal Commission of Great Britain on Physical
Training; Physical Training Among the Ancientfj the
Influence of Physical Training on the Health and Life of
the Individual; the Effect of Exercise on Brain Develop-
ment and Character; the Physiology and Pathology of
Exercise; the Relative Proportions of a Perfect Female
Form; Table of Standard Weights for Women; the Muscu-
lar System; the Benefits of Exercise; Passive Exercise; Mas-
sage; the Balance and Carriage of the Body; Common

10 CONTENTS

PAO»

PHYSICAL TRAINING THE KEY TO HEALTH AND BEAUTY (Con-
tinued)

Defects in the Carriage of the Body; the Heart's Need of
Exercise; the Gymnasium in the Campaign Against Dis-
ease; Gymnastic versus Athletic Training; Exercise After
Eating; Effect of Brain Fatigue on Body Fatigue, and
vice versa; Marks for Physical Efficiency; Advantages
Derived from Athletic Sports; Ethical Value of Sports for
Women; Forms of Athletic Games Best Suited to Women.

CHAPTER X

SYMMETRIC DEVELOPMENT: GOOD CARRIAGE AND GRACE OF
MOTION THROUGH GYMNASTICS AND ATHLETICS 323

Gymnasiums, Baths, and Athletic Associations: A Fun-
damental Part of a Woman's College and a Model Woman's
Club; the Vassar College Gymnasium; the Standardized
Percentage Table for Physical Efficiency; Special Medical
Blank for Women; Self-made Good Physique through
Physical Training; Rules for Taking Exercise; Gymnastic
Dress; the Configuration of the Foot; Correct Attitude in
Standing.

Corrective Exercises: Exercises for Developing the
Various Regions of the Body; Shoulder-blade Exercises;
Respiratory Exercises; Exercise for Forward Projection of
Chest and Retraction of Abdomen; Shoulder and Back
Exercises; Leg Exercises; Squatting Exercises for Muscles
of Spine and Abdomen; Alternate Kneeling; Abdominal
Exercises; Balancing Exercises for Poise and Carriage;
Balancing Exercises for Extending Depth of Chest; Lateral
Trunk and Waist Exercises; Exercises for Muscles of
Back; Exercises for Muscles of Abdomen; Swimming Exer-
cises for Back, Thighs, and Abdomen; Rope-pulling Exer-
cises for Back, Chest, Waist, Legs, and Arms; Exercises in '
Trunk Flexions for Back, Abdomen, and Legs; Exercises
with Chest Weights for Chest, Shoulders, and Arms; Box-
ing and Fencing; Classic and ^Esthetic Dancing an Essen-
tial Feature in Physical Training; Figures of the Dance with
Some Simple Exercises.

Outdoor Exercises: Effect of Walking on the Heart and
Lungs; Running; Mountain Climbing; Swimming; Horse-
back Riding as an Exercise; Rowing.

Athletic Sports: Croquet; Lawn-tennis; Golf; Hockey;
Basket-ball.

INDEX . . .375

PERSONAL HYGIENE

AND

PHYSICAL TRAINING FOR WOMEN

CHAPTER I

THE WISDOM OF PHYSICAL EFFICIENCY

Physical Efficiency as an Exact Science; Marks for Physical
Efficiency; Statistical Study of the Physical Examinations of 160
Young Women; the Physical Status of the Women of Today; the
Reflex Action of the Various Impairments of the Entire Organism.

"Circumstances," said Napoleon, "I make circumstances."

PHYSICAL efficiency stands for initiative, endurance,
success; it is the very keynote of modern life and has
become one of the burning questions of the day. West
Point and Annapolis have always recognized this, and in
order that their graduates should measure up to the high-
est standard of efficiency a most rigid physical examina-
tion was and is demanded as a prerequisite for admission;
and during the whole of the four years' course physical
training is systematically carried on so as to insure the
most perfect physique possible, with the result that in
addition to their great powers of endurance and initiative,
is their distinguished carriage and elegance of bearing.

To increase the safety of their passengers the railroad
companies were the next to demand these same physical
examinations to determine the efficiency of their applicants
and employees. Other large corporations followed.

So long as women remained in the home, or were willing

11

12 PERSONAL HYGIENE FOR WOMEN

and content to accept any small wage that was doled out
to them, the public did not seem especially interested in
their physical condition. But when women, as a large
teaching body or in any other public service, began to
demand equal pay for equal work, the situation was
materially altered, and in 1914 the English Royal Com-
mission summed up the following conclusions: "Where the
character and conditions of work performed by women
approach those of the work of men, the pay of the women
should approximate that of the men, but in so far as the
efficiency of men is higher, the salaries of men should re-
main higher." This at once changed the complexion of
the matter, and physical efficiency for women became a
matter of paramount and equal importance to both em-
ployer and employee.

Again, from the standpoint of social science, the physical
efficiency of women is demanded because they are the
mothers of the race, and on them, equally with the fathers,
does the welfare of future generations depend, since it is
believed that a child inherits equally from its parents —
one-fourth from father and mother each, one-fourth from
its grandparents, etc. The states are beginning to se-
riously take up the framing of laws for eugenic marriages,
•based on fixed standards of physical efficiency of the con-
tracting parties. And the day is not far distant when
women as well as men will have to undergo physical ex-
aminations to secure or hold any positions of importance.

Then, too, one of the results of the present terrible
European war has been to demonstrate that women pos-
sess a large amount of latent powers and endurance which
only needed for their development the same general
physical training that the state gives her sons. Women
are now being employed in these countries in all branches
of the civil service, as well as in agriculture and the making
of munitions, engaging in a vast number of employments
and trades hitherto considered unfit for women, because of
the great physical strength and endurance which they de-
manded.

13

Physical Efficiency as an Exact Science. — Physical
efficiency is growing to be an exact science; it is demon-
strable in figures. We have standardized percentage
tables for measuring the capacity of the lungs, the strength
of the heart and muscles, and, added to these, must be a
normal condition of the digestion, kidneys, generative
organs, sight, and hearing. If the sum total of these
amounted to 100 per cent., that would mean capacity for
the greatest possible endurance under strain, and so the
most effective worker; for there is a direct illation be-
tween the percentage standard of physical efficiency and
the output of work, both as to quantity and quality.

Marks for Physical Efficiency. — Sir Francis Galton, the
great English scientist, was the first to conceive the idea
of assigning marks for physical qualifications. They were
as follows: Breathing capacity, strength tests, both to be
regarded with reference to the height and weight; quick-
ness of response to a signal, made either to the eye or ear;
the sense of sight and hearing, and the color sense.

Realizing the usefulness of these tests in measuring the
physical efficiency, Professor Sargent included them in the
physical examinations of the Harvard students. The
strength tests consist of that for each forearm, of the back
and legs, the dip, the pull-up, and the lung capacity. The
combination of these seven tests is what is known as the
intercollegiate strength test, and is the best means as yet
devised for measuring the general muscular strength and
the respiratory power.

It is obvious that many of these tests would be needed
only by men going into the army or navy, or qualifying for
civil engineers or professional athletes, etc. So it was con-
sidered best to modify these tests to meet the require-
ments of physical efficiency for women.

For the large number of measurements of the arms, legs,
etc., included in the Sargent system have been substituted
the rating of the condition of the heart and circulatory sys-
tem, including the blood-pressure; lung and chest develop-
ment; digestive and nervous system; the kidneys and gen-

14 PERSONAL HYGIENE FOR WOMEN

erative organs; the muscular system; tests of endurance;
ocular and aural tests; with a final impression of the
working efficiency.

This standardized percentage table for physical efficiency
of women was worked out and the ratings made with the
able assistance of Dr. David Bovaird, Associate Professor
of Clinical Medicine, Columbia University, and Dr. George
A. Meylan, Associate Professor of Physical Education,
Columbia University; and it has seemed to us that this
combination of tests is of greater practical value, since the
maintenance of physical efficiency depends upon the in-
tegrity of all of the organs of the body. These ratings were
made to cover the Special Medical Blank for Women,1
gotten up for the examination of the women candidates of
the Presbyterian Board of Foreign Missions.

For many years the various Boards of Foreign Missions,
which are the great church corporations, have required
that candidates for this work should pass a physical ex-
amination similar to that demanded by the life insurance
companies, and so similar blanks were sent out to be filled
by the local examining physicians; but because of the
many breakdowns of the women on the field, and the great
detriment to the work and the expense thus entailed, four
years ago the Presbyterian Board of Foreign Missions de-
cided to have all of their women candidates re-examined
in New York by a woman physician especially appointed
by them for this purpose.

The results of these examinations have been most il-
luminating as to the physical condition of women who call
themselves well, to say nothing of what the medical pro-
fession in general seem to consider as standards of good
health in women who will be obliged to do very hard
work under most trying climatic conditions, which all
Life Insurance Companies rate as extrahazardous.

The composite picture thus obtained by the statistical
study of the physical examinations of these 160 young
women is of great value, not only because it is the first of
1 See page 330.

THE WISDOM OF PHYSICAL EFFICIENCY 15

the kind made for the first decade after leaving college;
but also because it is very fairly representative of the aver-
age physical condition of the great masses of women who
are engaged in teaching, social service, secretarial work,
etc.; and, further, it demonstrates the striking difference
in physique of women who call themselves well, and that
of the normal standard of physical efficiency to which
most of these women could have attained by properjJiys-
ical education.

Statistical Study of the Physical Examinations of 160
Candidates. — This study is made from the records of four
successive classes of young women coming from all over
the United States, city and country, including college and
non-college graduates, whose occupations were physicians,
teachers, students, nurses, social workers, housewives, etc.
All had passed a preliminary physical examination. The
average age was twenty-eight years, when woman should
be physically at her best.

/. Acute Diseases Since Childhood and Number of Days Lost Through
Illness. For Classes of 1913 and 1914 Only, Consisting of 100
Women.1

History negative — t. e., no history was given of any

acute illness after the children's diseases 30 per cent.

Acute illnesses, including operations 70 " "

Previous year's record :

Lost no days from illness 42 " "

Operations performed, followed by complete cure ... 27 " "

Marked loss of weight 23 " "

Total loss of time from illness, including postopera-
tive treatment, would equal entire time of one
woman for 8| months.

Of the acute illnesses, the following are of the greatest
interest because now preventable: Typhoid fever, 12 per
cent.; malaria, 6 per cent.; tonsillitis, 6 per cent.

Of the causes for operations, appendicitis leads with 13
per cent.; of these, 9 per cent, were simply for the removal
of the appendix; 2 per cent, for the removal of the ap-

1 Similar records for the rlnnnrn of 1915 and 1916 were not pre-
served.

16 PERSONAL HYGIENE FOR WOMEN

pendix and diseased right ovary; and 2 per cent, for the
removal of the appendix and ovarian cyst. The recovery
was not only complete from the operation, but the general
health was greatly improved in every respect.

Of the cases of tonsillitis, 4 per cent, were operated on
not only with complete recovery, but also with the cure of
rheumatism from which these women had previously
suffered.

II. Heart and Circulatory System.

Examination of heart negative, with absence of mur-
murs 97.5 per cent.

Action of heart weak 54.0

Pulse weak and rapid 50.0

Subnormal blood-pressure 63.0

Anemia present 55.0

Normal condition of veins 95.0

Subnormal temperature 40.0

Class average 7.5

///. Lungs and Chest Development.

Examination of lungs negative, with normal frequency

and character of respiration 97.0 per cent.

Subnormal chest girth in relation to height and weight,

of 51 inches 87.0

Subnormal chest expansion of 1 inch 82.0 " "

Subnormal lung capacity, measured by spirometer, 45

cubic inches 75.0 " "

Unhealthy condition of nose and throat (postnasal

catarrh or enlarged tonsils) 20.0 ' "

Class average 7.5

IV. The Digestive System.

Castro-intestinal indigestion was present in 35.0 per cent.

Hepatic congestion with tendency to bilious attacks . 20.0

Constipation 33.0

Catarrhal appendicitis (operation at once advised). . . 4.0

Class average 8.5

V. The Kidneys.

Urinalysis negative in 96.0 per cent.

Slight traces of albumin (with hyaline casts in 2 per

cent.) 4.0 " "

Floating kidney 0.8

Class average : 9.6 " "

THE WISDOM OF PHYSICAL EFFICIENCY 17

VI. The Generative Organs and Menstrual Function.

Pelvic organs normal 33.0 per cent.

History, menstrual periods normal 38.5

Displacements and inflammation, uterus 67.0

Accompanied by falling and inflammation of ova-
ries in 12.0

Hemorrhoids 3.0

Fibroid tumors 1.5

Dermoid cyst 75

Operations advised for retroflexed uterus and curetage 1.5

Dilatation and curetage 1.5

Class average 7.5

VII. The Nervous System.

Subject to headache 33.0 per cent.

Tendency to nervous exhaustion 11.0

Hysteric 3.0

Insomnia 7.0

Mental poise good 75.0

Class average 8.5

VIII. The Muscular System.

The average height 5 ft. 3 J in.

Normal weight 126 pounds.

Normal relation of weight to height and age 33.0 per cent.

Averaged 17 pounds underweight 47 .-0 " "

Posture good in sitting and standing 33.0 " "

Posture bad, round shoulders, stooped position, mus-
cles flabby 67.0 " "

Strength tests taken only for class of 1915 (30 women) :

Highest 802 points.

Lowest 338 "

Class average 570 "

Class average estimated 7.2 per cent.

IX. Tests of Endurance.

Took systematic daily exercise, walking 3 miles 25 per cent.

Took some exercise daily, 1 mile or under 50 " "

Took absolutely no systematic daily exercise 25 " "

Outdoor sports known, but not practised 10 " "

Test walk of 3 miles not given.

Heart reaction after exercise, hopping 100 feet, not given.1

X. General Impression of Working Efficiency.
Class average 8.2 per cent.

1 As the physical examinations are made during the time of the
Annual Conference, in order to shorten the time as much as possible
the Board requested that the tests of endurance be omitted.
2

18 PERSONAL HYGIENE FOR WOMEN

General Summary.

20 per cent, averaged from 67 to 75 per cent.

25 " " " " 75 to 80 " "

50 " " " " 80 to 85 " "

5 " " " " 90 to 95 " "

Class average estimated, 80 per cent.

Ocular Tests

Where the vision was normal, or had been corrected by glasses,
this was rated as normal; because of the occupations of these
women it was practically so.

The most striking points of weakness in the entire class
were the bad postures in sitting and standing, consisting
of round shoulders, a stooped position, and flabby muscles,
67 per cent. ; a deficiency of one-seventh of the normal chest
and lung development, accompanied by a deficiency of
one-third of the normal chest expansion, 85 per cent.;
weak hearts with weak and rapid pulse, subnormal blood-
pressure, and anemia in over 50 per cent. ; over 66 per cent,
had some form of pelvic trouble which was acting to under-
mine the whole system.

Aside from tuberculosis, life insurance companies re-
ject applicants who fall more than 20 per cent, below the
normal standard of weight, and because of this 16 per cent,
would have been rejected. The cause of this great loss of
weight was due to malnutrition and overwork, and had it
seemed practicable to adhere to Professor Meylan's wise
advice that anyone who fell below 7.5 per cent, in any
one series of tests, or below 75 per cent, in the general
average, 20 per cent, of the entire class would have been
turned down.

It- must be taken into consideration that these examina-
tions were made during the first week of June, at the end of
a hard year's work; but, making due allowance for this, the
results of these examinations have revealed such a subnor-
mal condition of the vital organs of the body as to be ap-
palling even to those of us who have long been familiar
with these subjects. In addition to this was the fact that
many unsuspected ailments needing immediate attention

THE WISDOM OF PHYSICAL EFFICIENCY 19

by physicians or surgeons were discovered in a class of
women who considered themselves well.

The Physical Status of the Women of Today. — The
strong presumption that the above statistics are very fairly
representative for the average woman of today is strongly
borne out by data furnished by the absence on account of
illness of the teachers of New York, and by correspond-
ing statistics recently published by the Life Extension
Institute of New York City.

Statistics compiled during the year 1913-14 showed that
more than 20 per cent, of the teachers of the New York
public schools were absent at some time on account of
illness, and that these absentees averaged 16$ school days.
The data obtainable showed four prevalent ailments:
diseases of the respiratory organs, 35 per cent.; acute
contagious diseases, 16 per cent.; nervous diseases, 15
per cent.; and digestive disorders, 11 per cent. And on
the health of the teachers ultimately depends the efficiency
of the entire educational system of the country.

The Life Extension Institute of New York, in its tabula-
tiori of 2000 examinations of young men and women clerks
between the ages of thirty and thirty-five years, showed only
3 per cent, normal, i. e., free from bodily impairments and
from habits of life which were leading to such impairments;
and showed 59 per cent, sufficiently impaired to justify
their recommendation to the definite care of their family
physician. "These statistics were compiled at an age
when the human being is supposed to be at the very prime
of life. The results prove that the majority of young men
and young women in New York City begin to die as soon
as they are grown up. Deaths due to degenerative dis-
eases have increased 86 per cent, in the past thirty years;
this means an increased death-rate whereby between
100,000 and 200,000 lives are lost every year."

The Reflex Action of Some of These Various Impair-
ments on the Entire Organism. — In the normal erect posi-
tion of the body the trunk is given its greatest length, the
head is held erect, the shoulders thrown back flat against

20 PERSONAL HYGIENE FOR WOMEN

the ribs, the chest is high, and the abdomen flat. (See
Plate III, Senegalese woman.)

In the bad postures noted in 67 per cent, of the entire
class, of round shoulders with a stooped position and
flabby muscles, we note four distinct and prominent fac-
tors in the breaking down of the human organism:

/.; The Effect on the Chest and Lung Development and
on the Action of the Heart. — In this malposition the upper
part of the body is inclined forward, with the result that the
chest is flattened to the extent of 1 inch. The restriction
which this must mean to the expansion of the lungs is
evident; and when it is realized that in the erect position
the heart occupies the space between the breast bone and
the spine, with practically no space to spare, the resulting
interference with the heart's action is evident.

It is a very serious matter when we have superadded to
a deficient chest development a deficient chest expansion.
For these are the very women in whom because of their
general run-down condition and undeveloped muscles
the breathing is very superficial; the apices of the lungs, the
favorite site of tuberculosis, and the deeper portions are
seldom expanded; and not only does the body suffer from
a deficient oxygen supply, but there is an equally defective
suction power on the part of the heart, which means a poor
circulation and a lowered general nutrition of the whole
body.

The main function in metabolism is oxidation, and
scarcely a step in the series of chemical changes proceeding
within the body is possible in the absence of an abundant
supply of oxygen, constantly renewed. Living in close
rooms lowers the vitality to an extent little dreamed of by
most persons.

II. The Effect on the Abdominal Viscera. — In the normal
erect position the abdominal muscles remain taut and
afford proper support and pressure to the abdominal vis-
cera and the great splanchnic circulation of large blood-
vessels; whereas in the stooped position the muscles of the
abdomen, not being properly used, become weakened and

THE WISDOM OF PHYSICAL EFFICIENCY 21

sag forward, causing the downward displacement of all
of the abdominal viscera, with consequent disturbance of
their circulation and function. Many cases of indigestion,
congestion of the liver, and constipation can be explained
in this way.

///. The Effect on the Circulation of the Spinal Cord. —
The circulation of the spinal cord is very largely dependent
on the tone of the muscles of the spine; hence the weakness
of these muscles interferes with its circulation. In the
spinal cord are large nerve-centers which have to do with
the control of the arms and legs as well as of the organs of
the trunk, so that anything which lowers the tone of these
centers depresses the vitality of the organs supplied by
them; and this is believed to be the cause of many cases of
so-called nervous indigestion.

IV. The Waste of Energy which Results from Faulty
Posture. — Weak foot, in its final stage flat-foot, is more
common in women than in men because it is not purely
a local condition in the arch of the foot, but primarily due
to a weakened condition of the leg muscles that support
the arch. Weak feet are gradually converted into flat-
feet by faulty standing and walking and lack of leg exer-
cises.

Many cases of nervous prostration are to be traced not
merely to overwork or worry, but to the waste of energy
which results from the faulty posture of the body and
with the interference of the circulation in the spinal cord,
and the consequent weakness of the nerve power which
results. In other words, it is not the load which breaks
the bearer down, but the way in which the load is carried.

Good chest and lung development, a strong heart, well-
developed and firm muscles are the tripod on which rests
physical endurance and resistance to disease. And this
was just where the entire class was found to be gravely
subnormal.

Physical training consists primarily of heart training; in
increasing the breathing capacity; in strengthening and
developing the heart and other muscles of the body. As

22 PERSONAL HYGIENE FOR WOMEN

the muscles become stronger the body is held more erect,
and this favors, as we have seen, all of its functions.

And it is not generally understood how great is the
effect of physical training on the brain and mental activ-
ities. With a strong and vigorous action of the heart
there is a feeling of courage and general exaltation; whereas
with a weak heart and feeble circulation fear and impaired
mental activity predominate.

The charge is constantly laid at the door of women that
they seldom rise above the mediocre, and have never been
leaders in the world of art, literature, the drama, science,
or the learned professions; that it is men who have invented
devices for the home!

According to statistics, of the 25,000,000 wage earners
in the United States, 8,000,000 are women, of whom
1,250,000 are over forty-five years of age and 637,000
under fifteen years of age. From an economic point of
view, anything which will raise the working efficiency of
one-third of our producing population, whose average wage
is now the paltry sum of $6 per week, must be welcomed,
because it not only prevents loss of tune from work, but
also the cost of illness. The study of the above statistics
demonstrates the fact that the physical efficiency of women
can easily be doubled; that should mean that the average
wage should be raised to $12 per week, which would be a
vast economic gain to the individual, the home, and to the
state.

CHAPTER II

HYDROTHERAPY

Description of the Skin; Functions of the Skin; the Physiologic
Effects of Water, Hot and Cold; the Chief Varieties of Baths; Ablu-
tions; the Tub Bath; the Alcohol Rub; the Cold Dip; Alkaline and
Saline Baths; the Rain Douche or Shower Bath; the Hot Foot-bath;
the Sitz Bath; Salt Ablution; the Turkish Bath; the Electric-light
Bath; Indications for the Use of Turkish Bath, and Contraindica-
tions; the Douche; Rationale of the Douche; Contraindications.

The Internal Use of Water; Its Action on the Heart and Blood,
on the Digestion; Therapeutic Indications for the Use of Water;
Contraindications for Drinking Cold Water.

Enemas; Vaginal Douche; Douching the Ear.

THE term hydro therapy will be used here in its broadest
sense, and may be defined as the hygienic and systematic
use of water, both externally and internally, for the preser-
vation and restoration of health and the prevention of
disease.

The hygienic and therapeutic value of the systematic
use of water is just beginning to be appreciated by the
medical profession. When this newly acquired knowledge
is put to practical use by the great masses of the people,
there will be a greatly diminished necessity for the use of
drugs. Indeed, water has been pronounced by a high
medical authority to be, and probably is, more nearly a
panacea for all human ills than any other known agent.

The bath is generally considered merely as a cleansing
procedure, whereas this is only one of its beneficial effects.
There is, in addition, the stimulation of all the functions
and organs of the body obtained through the temperature
of the water, and the mechanical stimulation which ia
obtained by the mode of application.

Again, the skin is not a mere covering for the body, but

23

24

PERSONAL HYGIENE FOR WOMEN

one of its most important organs, with well-defined func-
tions ; so that, in order to obtain a clear understanding
of the subject, it is necessary first to consider briefly the
functions of the skin; and, secondly, the physiologic
action of water.

Description of the Skin. — The skin is a very sensitive
and complex organ, and upon the condition of the skin
and the vicissitudes to which it is exposed the health of
the individual is dependent to a very great degree.

Fig. 1. — Vertical section of skin, sbg, Sebaceous glands; ep, epider-
mis; h, hair; d, derma (Fox).

The skin is composed of three distinct layers — the
epidermis, the corium or true skin, and the subcutaneous
connective tissue. The appendages of the skin are the
hair, nails, the sebaceous and sweat-glands. This com-
plicated structure is supplied with blood-vessels, lym-
phatics, and nerves.

The Epidermis. — The outer layer of this is the horny
layer; when a blister is formed, its fluid raises the entire
epidermis from the true skin. The flat scales forming the

HYDROTHERAPT 25

homy layer are continually being thrown off; this process
of desquamation is increased by the friction of the clothes,
of bathing, massage, and so forth, and is as constantly
being replaced by new cells from underneath.

The corium, or true skin, is the most important part of
the integument. This is a thick, felt-like tissue which is
pierced in all directions for the passage of the blood-ves-
sels, lymphatics, sweat-ducte, and nerves, and affords
lodgment for the hair follicles and sebaceous glands. The
tension of the skin is produced by its muscular structure
and elastic network, and is subject to temperature changes.
This power of contractility is known as the tone of the
skin.

The skin has two kinds of glands, the sebaceous and
sweat-glands. The sebaceous glands consist of a gland
structure, with a short excretory duct, which opens upon
the epidermis or into the hair follicles. These glands
secrete an oily substance, which keeps the hair and skin
soft and protects them from the sweat.

There exists in the sebaceous glands of the skin an
infinite number of vulnerable points for infection, and the
greater part of the process of cleanliness is directed toward
their protection. If in any part of the skin there is an
accumulation of bacilli, their toxins, or excretions, and,
at the same point, a collection of sebum, the friction of the
clothes, caused by the movements of the body, becomes
an active agent in effecting their absorption by the skin.
Hence, the scientific basis for the necessity of the daily
bath.

In the subcutaneous tissue we find the fat; it is this part
of the skin that contributes to the roundness and beauty
of the body. It is increased by abundant fatty food,
sedentary habits, and freedom from care.

Functions of the Skin. — The skin exercises three dis-
tinct functions, first, as an organ of sense; second, as an
organ of excretion; and third, as an organ of heat regula-
tion.

26 PERSONAL HYGIENE FOR WOMEN

Next to sight, the sense of touch is the most important
of all the senses. Through this sense the human organism
is made conscious of its contact with the outer world.
The cutaneous nerve-endings stand guard, as it were, over
most of the functions of the human body.

The importance of the action of the skin as an organ of
excretion will be better understood from the well-known
fact that the skin is one of the most important aids to the
kidneys. That the perspiration and the urine are to a
certain extent vicarious excretions has been proved.

The blood is the circulating medium which not only
serves to convey nutritive materials from the stomach to
the tissues, and the excrementitious materials from the
tissues to the excretory glands, but also to equalize the
body temperature. It conveys the surplus heat from the
interior of the body to the surface, where it may be dis-
sipated by conduction, radiation, and evaporation.
Nearly nine-tenths of the daily heat-loss takes place
through the skin; and of this, one-seventh is due to
evaporation, which is enormously increased by perspira-
tion.

The amount of perspiration produced daily is about
two pints, or in the neighborhood of -fa of the body weight.
This is double the amount of water thrown off by the
lungs. The watery portions of the perspiration are readily
evaporated, and the solid constituents are deposited upon
the skin. Urea and uric acid, together with more subtle
poisons, are found in the sweat.

Animal Heat. — The heat of the body is wholly derived
from foods, which, when completely oxidized within the
body, produce practically the same amount of heat and
energy that would be generated by their combustion out-
side the body.

But it is essential, in order to keep the body of warm-
blooded animals at a constant or normal temperature, that
an increase in the heat-production should be accom-
panied by a corresponding increase in the heat dissipa-
tion; the functions are reciprocal, and this equilibrium

HYDROTHERAPY 27

is regulated and maintained by a special nervous and
functional mechanism.

The automatic protective measures against the effects
of heat are :

First. — Dilatation of the cutaneous vessels and an
acceleration of the circulation through the skin and the
subcutaneous tissue. By this means the dissipation of
heat is increased; the sweat at the temperature of the
blood, deposited upon the surface of the body, evaporates
under favorable circumstances, and in this way consider-
able amounts of heat are abstracted from the body. In
consequence of sweating and its evaporation, the blood
circulating through the skin is cooled, and returning to
the internal organs at a lowered temperature, prevents
their overheating.

Second. — Should the action of heat be continued for a
greater length of time, a large amount of blood will be
retained in the skin in consequence of the loss of tonicity
of the cutaneous vessels; the cutaneous circulation will be
slowed, and thereby the blood, heated at the surface of the
body, is prevented from returning to the internal organs
and so overheating them.

Third. — In consequence of the accumulated amount
of blood in the skin, a diminished amount of blood will
remain in the internal organs; thus their activity, and
thereby also the production of heat, will be lessened.

In these processes will be found a safeguard against the
excessively rapid penetration of heat to the internal
organs, and against the unduly rapid elevation of the
body temperature through thermic influences.

As a result of the stimulating influence of cold, there
first occurs contraction of the skin and its vessels. This,
by restricting the dissipation of heat, brings about perfect
compensation if the abstraction of heat be but slight;
and but partial compensation, if the abstraction of heat
is more marked. In the latter event the body tempera-
ture will continue to decline, to a greater or less degree;
in the former it will remain constant.

28 PERSONAL HYGIENE FOR WOMEN

The role played by the skin in maintenance of the nor-
mal temperature of the body is indispensable.

The normal temperature of the adult human body is
98.6° F. in the mouth, and that of the rectum and vagina
is one degree higher.

Fasting, sleep, and short applications of heat all decrease
heat-production; during sleep the temperature of the body
falls half a degree or more.

Respiration by the skin varies from \ to 1 per cent,
of the total amount of oxygen taken into the body, and a
somewhat lower percentage of carbonic acid is thrown
off through this channel.

The skin absorbs substances in watery solutions with
difficulty, on account of the oil lying upon and in the
epidermis; substances dissolved in oil and rubbed in are
more rapidly absorbed; absorption takes place rapidly after
the skin has been washed with ether, chloroform, or alcohol.

The Physiologic Effects of Water. — These depend
on whether the water is taken internally or applied ex-
ternally. If applied externally, the effects will depend
upon the temperature, whether hot, tepid, or cold;
also on the manner of application, but, most of all, on
the length of time which it is applied and the state of
health of the individual.

The temperature of water is classified as very cold, from
32° to 55° F.; as cold, from 55° to 65° F.; cool, from
65° to 80° F.; tepid, 80° to 92° F.; warm, 92° to 98° F.;
hot, 98° to 104° F.; very hot, 104° F. and above.

Heat. — A general hot bath produces dilatation of the
vessels of the skin and contraction of the vessels of the
brain; a general activity of the glands of the skin, both
perspiratory and sebaceous. Perspiration may be pro-
duced, either to the degree of slight moisture or of profuse
sweating, according to the length of time and the intensity
of the application made. In a very hot bath the rate of
perspiration may be increased from fifty to sixty times
the ordinary amount. The most pronounced effect pos-
sible may be secured by either the electric light or sun bath.

HYDROTHERAPT 29

Loss of fluids from the body has a depressing effect
similar to, though somewhat less marked than, that
produced by bleeding, so that there is a vital necessity for
administering water internally before, during, and after
the bath.

Prolonged and repeated perspirations induced by
artificial means weaken the skin, and thus lessen its-
power to resist cold impressions, unless counteracted by
frequent cold applications.

The general and usual reactions following the applica-
tions of heat are atonic and depressing in character. For
the most part, the reactions following cold applications
are to be preferred to those following hot ones.

The three great vascular areas of the body are the mus-
cles, the portal system, and the skin. Each of these
parts may be regarded as a great reservoir, capable of
retaining a large part of the entire amount of blood of
the body. When one of these areas is in a state of con-
gestion, the others must be in a comparative state of
anemia.

The restorative effects due to the application of heat
are due partly to the elimination of fatigue poisons which
is thereby encouraged, as well as by the reflex stimulation
of the nerve-centers. The good effects are much more
decided and lasting, and the exhausting effects neutralized,
if the hot application is followed by a short cold one.

The effects of a neutral bath, 92° to 95° F., is sedative,
diminishing nervous irritability.

A hot-water bottle or fomentations, placed over the
stomach for an hour or two after eating, increase the
gastric secretions, and, when placed over the liver,
increase the flow of bile.

The Physiologic Effects of Cold.— In suitable cases a
short general application of cold is a powerful heart tonic.
Cold causes a contraction of the vessels of the skin and
of those of the brain, with a dilatation of the internal
vessels. There are pallor and coldness of the skin, and
an almost instantaneous suspension of perspiration,

30 PERSONAL HYGIENE FOR WOMEN

which is dangerous only when the body is in a state of
fatigue.

If the application of cold is long continued, the surface
becomes blue, the temperature of the muscles beneath the
skin is lowered, thus checking heat-production in these
muscles; the circulation is slowed, and the heart's action
is diminished in frequency. There is a gooseflesh appear-
ance of the skin; a sensation of chilliness, trembling,
shivering, chattering of the teeth; at first a quickening
and then slowing of the pulse, and deep gasping respira-
tion.

When the cold application is considerably prolonged,
the tendency to reaction is suppressed. There is an ex-
haustion of the nerve-centers as well as of the heat-
producing powers of the body. Thus, the system grad-
ually loses its power to resist the depressing effects of
cold. The repeated chillings of the body increase the
length of time required to return to the normal tempera-
ture. Applications of water below the temperature of
the body always lower the temperature.

Reaction. — If the application of cold is of very short
duration, of very low temperature, and given under high
pressure, the phenomena of reaction begin immediately
on its cessation.

The reaction consists in a dilatation of the surface
capillaries, with contraction of the internal vessels; red-
ness of the skin; the skin is smooth, soft, and supple;
there is a sensation of warmth, comfort, and well-being;
respiration is slower and deeper; there are a fall of the
internal temperature and increase of perspiration.

Certain measures to favor reaction should be taken
before the bath, such as exposure to the air of a warm
room, drinking hot water, and short exercise of a rather
vigorous kind.

During the bath the measures which favor reaction are
short, sudden applications of cold, friction while in the
bath with the hand, and pressure effects in the douche.

After the bath reaction is favored by vigorous rubbing,

HTDROTHERAPY 31

a thorough drying of the body, warm clothing, warm air
of the room, and as vigorous exercise as the strength of
the individual will permit.

Conditions which are unfavorable to healthy reaction
are: old age, infancy, exhaustion, either temporary or
from an excessive loss of sleep, or extreme nervous ex-
haustion, obesity, rheumatic diathesis, unhealthy or
inactive skin, profuse perspiration when accompanied
by a state of fatigue, extreme nervous irritability, a very
low temperature of the skin, an immediately preceding or
impending chill, and extreme aversion to cold applications.

The average temperature of the human nude skin is in
the neighborhood of 90° F. The difference between the
temperature, of the skin and water is the chief element in
determining the reaction of the individual. It is evident
that water at a temperature of 90° F. would be neutral or
indifferent; the difference of intensity of effect is in pro-
portion to the difference of temperature of the water and
skin. The duration of the cold procedure is an important
element in the production of reaction. It may be laid
down as a rule never to give any cold-water application
without friction. The physical and psychic state of the
individual exerts more or less influence upon his reactive
capacity. An anemic, or otherwise depressed individual
must be managed with great circumspection, because she
bears heat abstraction badly. The hydriatic procedure
must always be adapted to the reactive capacity of the
bather.

The woman must be thoroughly rubbed after the bath
until a good reaction has occurred. Especial attention
must be paid to the feet and legs. The bather should
first be rubbed with a warm towel or sheet, and then with
the bare hands of the attendant, as the warm hand greatly
facilitates the reaction. The bather is by no means dry
when the skin ceases to feel wet. So long as the skin is
soft and spongy, it still contains moisture which has been
absorbed by the superficial layers of the epidermis. The
absorbed moisture, being left to evaporate after the bath,

32 PERSONAL HYGIENE FOR WOMEN

the individual is liable to become chilly and contract a cold,
which is erroneously attributed to the bath itself.

Other injurious effects following imperfect reaction
after the cold bath are secondary chills or a continuous
chill lasting for several hours. The hands and feet are
cold, there is headache, not infrequently diarrhea, and
other evidences of internal congestion, such as abdominal
or ovarian pain, vertigo, etc.

Reaction may be favored by covering the patient with
blankets, surrounding her with hot-water bottles, and
giving her hot tea to drink. Exercise should follow the
bath. Walking for from twenty minutes to an hour is
the most usual form of exercise. Very vigorous exercise
for a short time cannot be substituted for moderate
exercise for a longer time.

The Tonic Effect of Cold Upon the System. — The effect
of cold upon the muscles, when given in the form of a cold
bath, douche, or spray, is to augment muscular energy
and tone to a very great extent; this increased muscular
tonicity is the cause of the slight shivering. The cold
douche, if short, — one or two seconds, — and given with a
pressure of from 25 to 30 pounds, is a powerful restorative
in fatigue resulting from severe muscular effort, but it
must be immediately preceded by a short hot bath, and
must be followed by vigorous rubbing and wrapping' in a
hot blanket.

Short cold applications cause elevation of temperature
and increased metabolism, while prolonged cold applica-
tions cause a fall of temperature and decrease of metabo-
lism.

The tonic effect of cold water is believed to be due
to the stimulation of the sympathetic nerve-centers. The
sympathetic nervous system controls the blood-vessels,
heart, the functions of secretion and excretion; and, in-
deed, all the vital functions of the body.

The sensation of well-being which accompanies the
reaction following a general cold application is largely
due to an increased activity of the cerebral circulation.

HYDROTHERAPY 33

Cold water is a physiologic tonic, and the cold bath, prop-
erly employed, increases the vital resistance to pathologic
processes.

All applications of water at a temperature low enough
to provoke vital resistance are tonic; hence, tonic effects
are produced by all temperatures below 90° F., but the
most certain and pronounced results are obtained from
the douche in every form, which adds mechanical impact
to the thermic effects of cold. The most durable tonic
effects are produced by the frequent use of very cold and
very short baths.

A tepid bath causes a lowering of the body temperature.

The Chief Varieties of Baths. — These, in the order
of frequency with which they are used, are: ablutions;
tub; foot-tub; sitz; salt sponge; shower; Turkish; hori-
zontal jet; needle; fan douche; Scotch douche; Roman and
electric-light baths.

Ablutions or Sponge Baths. — These baths are of
universal use. The sponge is one of the dirtiest and most
impossible articles of the toilet to clean and to keep clean.
It is a collector of dirt and germs, and should be banished
from every bath-room and from every house. It is not
sufficient that each member of the family should have
her own sponge; it is quite possible for the individual to
become infected or reinfected from her own sponge.
Incidentally, it does not afford sufficient friction, and thus
does not favor reaction. In taking ablutions, the ap-
plication of water may be made with the hand, though it
is best made by means of a wash towel. The good effects
of the simple ablution will be greatly enhanced by the use
of the hat tub, and this especially where there is no bath-
tub in the house.

When the bath is taken for the purpose of cleanliness,
the water should be warm or hot, and pure Castile soap is
one of the best that can be used. If the skin is rough, a
good sand soap will be more beneficial. The bath should
be completed by dashing cold water over the body with
the wash-towel.

3

34 PERSONAL HYGIENE FOR WOMEN

The body must be quickly and thoroughly dried by
means of a rough bath-towel. After this, the skin may
be still further toned up by a good alcohol rub.

If the ablution is taken simply for the tonic effect, it is
generally taken on rising in the morning, and the water
used is cold. The ablution may be confined to the upper
part of the body, that is, the chest and back ; and consists
in friction with a rough wash-towel, followed by dashing
the water over the body; followed by brisk friction with
a rough bath-towel. This procedure causes a marked
stimulation of the heart and lungs, and is followed by a
rise of temperature.

In winter all baths must be taken in a warm room.

There is a decided increase of muscular and mental
capacity after the cold ablution, demonstrating the tonic
effect it has produced.

The cold ablution may also serve as an introductory
to other and more heroic hydriatic procedures. If the
reaction is not good, water at a higher temperature should
be used, and only small portions of the body should be
attacked each day, followed always by brisk friction.
As the reaction becomes better, the temperature of the
water should be gradually lowered from day to day.

There must be a decided sensation of warmth of the
body before proceeding to take any form of cold bath.
This may be induced by sipping a cupful of hot water
before rising, and then being well covered with the bed-
clothes until the body is in a glow. In conditions of
anemia or neurasthenia, where the circulation is markedly
poor, in addition to drinking the hot water, the bather
may stand on hot blankets while taking the cold ablu-
tion, and after it be rubbed briskly with hot towels.

Nothing is gained, and a great deal of harm is done, by
trying to persevere in the daily cold ablution when it is
followed by a pallor of the skin, chilliness, etc.

The Tub Bath. — This is much more refreshing, more
salutary, and may be used to produce a much greater
variety of effects than the simple ablution. Tub baths

HYDROTHERAPY 35

may be classified according to the amount of water in the
tub as half or full tubs; and again, according to the tem-
perature of the water, as warm, tepid, hot, and cold.
The half tub contains about 30 gallons of water.

In a general way it may be said that the half tub of
warm water is used for the purpose of cleanliness; the hot
baths for breaking up colds, for rheumatism, etc.; the
tepid bath to allay nervousness; and the full cold tub, for
the tonic morning dip.

For cleansing purposes the so-called half tub, that is,
the tub contains a sufficient amount of water to reach
above the pelvis when one is seated in the tub, is used.
The temperature ranges from 98° to 102° F. Five min-
utes is as long as the bather should remain in the tub,
as all hot baths are more or less exhausting. After an
initial immersion in the water, the scrub takes .place by
means of the Turkish bath-towel, or, better, by the use of
the flesh brush. If there is a shower attached, the hot bath
should always be followed by a brief cold shower; if not,
the cold water should be turned on and dashed over the
body by means of the wash-towel. This closes up the
pores of the skin, prevents the profuse perspiration from
taking place that so often follows a hot bath, and greatly
diminishes the susceptibility to taking cold. An alcohol
rub completes the procedure. This insures a further
toning up of the cutaneous vessels. A small quantity
of alcohol is poured into the hand and applied to a limited
area of the body. It is well rubbed in with friction until
the alcohol has wholly evaporated. Beginning with the
arms, the legs, chest, and back are successively gone over.

The hot bath is best taken immediately before retiring,
and should not be repeated oftener than twice a week.
Retiring to bed at once, the bed acts as the cooling cham-
ber of the Turkish bath. The hot bath is most restful,
and, except in rare cases, tends to the production of
refreshing sleep.

If the bather has a weak heart, suffers from shortness
of breath, or is weak from any cause whatever, she should

36 PERSONAL HYGIENE FOR WOMEN

only take a half tub bath, since it has been learned from
experience that when the water covers the entire body,
there is increased difficulty in the respiration, and the
heart's action often becomes embarrassed, palpitation
of the heart is experienced, with a feeling of impending
suffocation. There is sometimes also a feeling of faint-
ness. On getting into the tub, the temperature of the
room should never be above 68° to 70° F.

The Full Tub or Immersion Bath. — In this form of bath
there is a complete submersion of the body in the water,
so that the water reaches the under surface of the chin,
the head of the bather resting on a cross strap, being the
only portion of the bod}7 uncovered by the water.

If the bath is tepid, that is, has a temperature of from
80° to 90° F., great care should be taken to have the
chest covered, in order to prevent pulmonary congestion.
This is best accomplished by placing a Turkish towel,
wrung out of hot water, about the chest and shoulders
of the bather just after she enters the tub.

If the bath is hot, from 98° to 104° F., before entering
the bath the face and neck are rubbed with cold water,
in order to relax the vessels of the brain and so prevent
cerebral anemia. Except when the hot bath is given for
especial therapeutic purposes, as for rheumatism, cystitis,
colic, etc., it should always be followed by a cold applica-
tion.

The Cold Dip.— For the dip, the tub is filled with
water at a temperature of from 65° to 55° F. The dura-
tion of the dip varies from two or four seconds to one or
two minutes. The bather should wet the face and chest
before entering the water. It is best to enter the bath
suddenly, as the sensation of cold is thus far less notice-
able than when the bath is entered gradually. If the stay
in the tub is more than momentary, vigorous rubbing
must be kept up during the entire time spent in the tub.

For persons in good health a cold dip on rising in the
morning is excellent. It creates an appetite, accelerates
the circulation, arouses the nervous system, and produces

HYDROTHERAPY 37

decided exhilarating effects in those who are strong
enough to react after it. When employed for this pur-
pose, the immersion should not be more than from three
to fifteen seconds. The bather must rub herself vigor-
ously while in the tub, and follow the bath with brisk
toweling and plenty of friction. She should then take
moderately active exercise for fifteen to twenty minutes.

For any one just beginning to take the cold dips, the
temperature of the water should be just 1 degree below
that of the body, and gradually lowered by a drop of 1
degree every morning or two. Or, the dip may be pre-
ceded by a preliminary warm bath or warm shower.

The salient point in connection with bathing is not to
allow the skin to lose heat too rapidly. To apply this as a
warning in the case of cold baths: it has been estimated
that the heat loss from the body immersed in cold water
at the temperature of 86° F. is double the normal; at
77° F., three times, and at 68° F., five times, the normal.

The daily use of the cold dip for those who are able to
react after it is one of the bes.t means of fortifying the
system against both acute and chronic diseases.

Contraindications. — The use of the cold dip is contra-
indicated for young children, the aged, and in run-down
conditions of the system; in all cases where the action of
the heart is weak, in Bright's disease, or in any acute or
chronic congestion of the kidneys; in all acute inflamma-
tions, as inflammation of the bowels, peritonitis, or in-
flammation of the uterus and ovaries.

Alkaline Baths. — For these baths from 4 to 12 ounces
of the carbonate of soda should be used to 30 gallons of
water. The water should have a temperature of from
92° to 96° F. This bath is useful in many forms of skin
disease, and relieves the itching of jaundice and urticaria.

Saline Baths. — The typical saline bath is the salt-
water bath. Sea-water contains in solution from $ to
i pound of solids to the gallon of water. The principal
ingredients are common salt, magnesium chlorid, and
magnesium sulphate. These substances have a decidedly

38 PERSONAL HYGIENE FOR WOMEN

stimulating effect upon the skin and encourage reaction.
For an artificial sea-water bath, 8 pounds of sea-salt
should be used to 30 gallons of water.

Ordinary coarse salt is purer, contains from 97 to 98
per cent, of the chlorid of sodium, is cleaner, and makes
a clearer solution, and it dissolves in about one-third of
the time required for sea salt, and can be obtained for
about one-third of the cost.

As a cleansing agent, a 5 per cent, brine is equal or
superior to soap. Further, the axilla and hairy parts
remain clean and sweet for a much longer time than after
the use of soap. These brine baths, taken three times a
week, are followed by a great improvement in the general
health.

The Rain Douche or Shower Bath. — The shower is
the most tonic of all the baths that can be taken at home,
and no bath-room should be considered complete without
it. In this form of douche the water is projected through
a perforated disc, falling upon the bather in a number of
fine streams. It is necessary for the bather to wear a
rubber cap in order to keep the hair dry. In taking the
shower bath the bather stands up; the disc is generally
placed about 3 feet above the head. The water should
be allowed to fall first upon the feet, then the hands, arms,
shoulders, back, and, lastly, upon the chest and abdomen.
The bather should keep in active motion during the ap-
plication, flexing the limbs, and rubbing the chest with
the hands. At the beginning of the shower the hands
should be placed over the chest, in order to protect the
precordial region from the impact of the water.

The cold shower should be preceded by some kind of a
heating process — either a hot plunge or a hot shower bath.
A shower of from 100° to 104° F. may be applied for one
to three minutes before the cold application. A cool
shower of 75° to 65° F. is an excellent training for persons
who are sensitive to cold. The neutral shower, 92° to
97° F., given for three to five minutes, is sedative in its
effects.

HYDROTHERAPY 39

The cold shower, 60° to 70° F., duration from five to
thirty seconds, is useful in phlegmatic neurasthenics and
dyspeptics; sedentary people in whom the general meta-
bolic activity is diminished ; also in obesity and in all cases
after a sweating process. By standing in hot water the
bather is much more tolerant of cold.

The neutral shower is one of the most effective measures
for the relief of insomnia; especial attention should be
given to the back and legs. The action is quicker than
that of the neutral immersion bath.

As a hygienic measure, the shower bath offers a most
agreeable and rapid means of cleansing the whole surface
of the body.

Since the effect of the douche depends on the pressure,
it will be readily understood that the hose attached to the
faucet of the domestic bath-tub is merely a sprinkler,
and not a douche, in the proper sense of the word. Such
a procedure can only be tolerated by the most robust.
In the upper stories of most city houses the pressure is
probably not more than from 3 'to 10 pounds; the stream
of water from the sprinkler is really only a drizzle; the
mechanical effects being so slight, there is no reaction
produced ; the result is that its use is followed by a feeling
of chilliness and depression.

The Hot Foot-bath. — The temperature of this bath
should be at the beginning from 102° to 104° F., and the
duration from three minutes to half an hour. The pail
is nearly filled with water, care being taken that it shall
not be so full as to overrun when the feet and legs of the
bather are put in. A blanket, closely wrapped about the
patient and the pail, should come up above the knees.
As the water cools off, hot water should be added.

This form of bath is most commonly used to relieve
congestion and inflammation. The dilatation produced in
the blood-vessels of the feet and legs relieves congestion of
the brain and the organs of the upper half of the body,
as well as of the pelvic viscera. It should be taken imme-
diately before retiring.

40 PERSONAL HYGIENE FOR WOMEN

The Sitz Bath. — The sitz or hip bath requires a tub
made for that particular purpose. The back of the tub,
which is most commonly made of tin, is cut high, while the
front must be sufficiently low for the patient to sit com-
fortably in it, without undue pressure being made on the
under side of the knees.

The tub is half filled with water of the prescribed tem-
perature. It is well to begin with water at a temperature
of 102° F., and increase the temperature while the patient
is in the tub, making it as hot as is comfortable.

In giving all hot baths a thermometer must be used, and
a word of warning must be given about adding hot water

Fig. 2. — Sitz-bath tub made of tin (Ash ton).

in case of sickness, as well-authenticated cases of paral-
ysis are recorded in which the temperature sense of the
patient was lost, and, in adding hot water, it was raised
to such a temperature that the legs and feet of the patient
were scalded.

During the sitz bath the patient keeps on her stockings
and bedroom slippers, and, unless friction is ordered, the
entire body, as well as the feet and legs, are enveloped in
blankets.

The duration of this bath is from three to ten minutes.

HYDROTHERAPY 41

This bath is especially useful in restoring the menstrual
function when it has been suspended as the result of
chill or other causes; also, for relieving hemorrhoids,
uterine colic, neuralgia of the ovaries, and inflammation
of the bladder.

To prolong the effect of the bath the patient may be
put to bed wrapped up in her blankets. In cold weather
it is a good precautionary measure to have the bed heated
with hot-water bottles, in order to prevent chilling.

Salt Ablution. — As the name indicates, this is a salt-
water bath, and the best results are obtained by using
a saturated solution, which is in the proportion of 1 pint
of salt to 1 gallon of water. Sea-salt is the best, but, if
that cannot be obtained, ordinary salt may be used.

If there is no bath-tub in the house an ordinary wash-
bowl may be used, but the bath is most effective when
taken in the tub. The salt and water are put in a papier-
mdche' pail, which is placed at the foot of the tub. The
chilliness which might be caused by sitting on the cold
porcelain is avoided by placing a' heavy folded bath-towel
on the bottom of the tub. In cold weather the tub
ahould be previously heated by allowing the hot water
to run in.

The salt water feels very much colder than plain water
at the same temperature. It is well to begin with a tem-
perature of from 90° to 85° F., and gradually lower the
temperature until 70° F. is reached.

The water is applied by means of a Turkish wash-
towel, accompanied by vigorous friction, beginning with
the face and neck, arms, legs, back, and, lastly, the chest
and abdomen are gone over. After that, the water is
dashed over the entire body, and is followed by a brisk
toweling and friction with the hands or hair glove.
The salt water should not be washed off, except in those
rare cases where it causes a disagreeable sensation; it is
then removed by the use of the hot followed by the cold
shower, as previously directed.

Indications for Its Use. — It is an excellent nerve tonic

42 PERSONAL HYGIENE FOR WOMEN

in cases of depression with loss of appetite, insomnia,
etc., also in anemia and neurasthenia. In this class of
cases it is best taken in the afternoon, on rising from the
siesta, and just before dressing for dinner. It is especially
refreshing in the hot weather.

Its use is contraindicated under the same conditions that
other cold baths are, and must never be taken when the
bather has a tendency to chilliness.

The various kinds of baths previously described can all
be obtained in the home, but the Turkish bath, with its
various accessories, can only be taken in a properly
equipped bathing establishment.

The Turkish Bath. — This form of bath dates back to
the time of the Romans. The essential features of a
modern establishment are : dressing-rooms ; a warm room,
with a temperature of from 110° to 130° F.; a hot room,
temperature of 150° to 170° F.; a steam room; a shampoo
room; a douche apparatus; a plunge bath, and a cooling
room. In many establishments there is only one hot,
dry-air room. The air of the room may be heated by
steam-coils.

The bather, having disrobed, is enveloped in a sheet,
and enters the hot room, where she reclines on a steamer-
chair. A towel wrung out of cold water is placed on the
forehead and changed as often as it becomes hot. The
bather should drink a glass of cold water immediately
before or on entering the hot room, and several glasses
should be taken at intervals during her stay in this room.

The skin is highly stimulated and profuse perspiration
results. The profuse sweating promotes absorption from
the alimentary canal, and so is a powerful stimulant to
nutrition. It also emphasizes the necessity for copious
water-drinking.

Great harm often results from a too prolonged stay in
this room. Ordinarily, the bather should leave the room
as soon as free perspiration is established ; that is, in from
fifteen minutes to half an hour.

From this room the bather next enters the Russian

HYDROTHERAPT 43

bath or steam room. It is very much more agreeable to
have very little steam in the room on entering; when the
steam is very dense, a feeling of suffocation may occur.
Any one with a weak heart should avoid the steam room
altogether, as it is apt to cause a sense of great oppression.
For the complexion, bronchitis, or laryngitis, it is excellent.

From the hot room the bather goes to the shampoo-
room, where, lying upon a marble slab, she is first gone
over from head to feet by the wet hands of the attendant.
This manipulation removes the layer of cuticle which has
been loosened by the free perspiration. These rubbings
and strokings are continued until the skin feels smooth
and polished.

The bather is next shampooed with soap and water,
applied with a bath-brush. This^may in turn be followed
by a salt rub. After this comes a douche, given with a
horizontal jet, at a temperature of 104° to 106° F., fol-
lowed by a cold douche.

If the bather is a strong woman, she may now enter the
cold plunge. The temperature of this should be from 70°
to 60° F. ; this must only be a quick dip. She is then
vigorously rubbed and dried. After this she lies down in
the cooling room and has an alcohol rub, which completes
the procedure. She should rest here for half an hour at
least before dressing. The pulse should be normal and
the skin perfectly dry before she dresses and goes out on
the street.

In winter, instead of the ordinary alcohol rub which is
given, it is much better to have a thorough massage with
cocoa-butter or almond oil — the so-called Roman bath.
Just following the Turkish bath much of this oil will be
absorbed, which is beneficial for thin people, and, in any
case, it will lessen the danger of getting chilled on going
out into the cold air.

The woman unaccustomed to these baths should under
no circumstances go to a Turkish bath without consulting
her physician, as great harm might result. The bath
should not be taken oftener than twice a week, unless by

44 PERSONAL HYGIENE FOR WOMEN

special orders of the physician. Care must be taken not
to overuse them, as frequent and prolonged exposures
to the sedative influence of heat is very debilitating.
The wise woman will provide her own bathing cap, bath-
brush, and straw sandals.

The use of the Turkish bath is indicated in rheumatism,
toxemia, chronic dyspepsia, biliousness, obesity, sciatica,
and lumbago.

The contraindications to its use are, in Bright's disease
of the kidneys, in most pulmonary affections, in the ad-
vanced stages of arteriosclerosis, and in diabetes with
emaciation.

The Electric-light Bath. — This is now frequently
used instead of the hot-air room of the Turkish bath, and
possesses many advantages. A cabinet is lined on three
sides with mirrors, on which are arranged 50 or 60
electric-light bulbs; the mirrors multiply the number of
lights by reflection. A stool is placed in the cabinet for
the patient to sit on, while the head protrudes above the
top, which is closed. By means of switches and a proper
grouping of the lamps in wiring, the number of lights, and
so the temperature, can be instantly and perfectly con-
trolled. The heat is derived by radiation, so that it is
not necessary to have the air confined. In this form of
light bath the body is directly exposed to the effects of
radiant light and heat.

The incandescent electric-light bath is superior to every
other form of heating procedure in which the only object is
the preparation for the cold bath. The time required
is not more than from three to five minutes. When it is
desired to produce profuse perspiration, the patient may
remain in from eight to fifteen minutes. A longer stay
than this is apt to produce an over-stimulation of the
nervous system and an excessive elevation of tempera-
ture.

The electric-light bath possesses the distinct advantages
that, while the body is exposed to a high degree of heat,
the air of the room in which the head is, and which one

HYDROTHERAPY 45

is breathing, may be cool, and unique advantages in the
exactness of the dosage as regards time and intensity.
It can also be used in a much greater number of diseases
than the hot-air room of the Turkish bath.

The finishing treatment on leaving the cabinet is iden-
tically the same as that for the ordinary Turkish bath.

Indications for Its Use. — While the electric-light bath
is not a complete substitute for sweating produced by
exercise, it comes nearer to that than any other heating
procedure, and, when followed by some vigorous cold
application, it possesses a hygienic value which cannot be
overestimated.

It is especially valuable in cardiac disease and diabetes.
It stimulates oxidation, and is thus valuable in obesity
and the toxemia of chronic dyspepsia; also in malarial
cachexia, syphilis, neuritis, neuralgia, sciatica, habit
chorea, hysteria, rheumatism, and anemia.

It is superior to all other treatment in chronic rheuma-
tism and all diseases dependent on uric-acid diathesis or
diminished metabolism, by the combined action of the
elevation of temperature and the vigorous cutaneous
activity. The elevated temperature stimulates the oxida-
tion of the proteid wastes and augments vital combustion,
while the increased skin activity carries off all waste-
products prepared for elimination.

As a prophylactic, this form of bath is especially valu-
able for all persons leading a sedentary life; it is the best
substitute for exercise in the open air, and, where there
are no contraindications to its use, should be taken once a
week.

In cases of obesity, sweating may be used to reduce the
weight; but, in order to obtain the best effects, it must be
combined with exercise, and it must be borne in mind,
that in obesity there is great danger of overheating the
blood, in consequence of the obstacles to heat elimination
presented by the thick layers of non-conducting fat. There-
fore, these hot applications for the reduction of fat should
never be too much prolonged, and the bath should always

46 PERSONAL HYGIENE FOR WOMEN

be finished by vigorous applications of cold. These
cold applications have also a tonic effect upon the nervous
system, and increase the muscular disposition for exercise,
and this is the most rational treatment for obesity.

Loss of Weight. — There are many cases in which metabo-
lism has been so sluggish, allowing an accumulation of
imperfectly oxidized matters in the body, that the first
active stimulation of the nutritive processes is in dis-
proportion to the increased destructive metabolism.
Under these circumstances there is necessarily a decrease
in weight. The rubbish must first be removed and
old defective structures before new and highly organized
tissues can be deposited. A slight loss of weight need,
therefore, give rise to no apprehension, but if the loss is
considerable, or continues for seme time, especially if
accompanied by loss of strength or appetite, it is a matter
for investigation.

Palpitation of the heart and fulness of the head are an
indication that the applications have been too hot or too
long continued. Vertigo and fainting are apt to occur
when hot applications have been continued too long, but
they are quickly relieved by cold applications, especially
by cold affusions to the chest and shoulders. Headache
may result, either from excessively hot or cold procedures.
Deficient reaction is generally the result of a too prolonged
application of cold.

On entering the electric-light cabinet, a wet towel
wrung out of ice-water is placed around the neck and
another around the forehead; or an ice-bag may be placed
on the top of the head.

The Douche. — A douche consists of a single or multiple
columns of water directed against some portion of the body.
The apparatus is complicated, and it is essential that an
accurate pressure-gauge and thermometer should be intro-
duced into the circuit of the douche. It can only be
properly administered in a hydriatic establishment. In
the employment of the douche three factors must be con-
sidered— the temperature, pressure, and the mass.

HYDROTHERAPY 47

The range of temperature employed varies from 45°
to 125° F. The pressure ordinarily employed varies from
10 to 60 pounds. The mass varies according to the effect
desired, and may be regulated by means of the finger,
placed in the water column near the nozzle.

The douche is applied by means of the rubber hose,
which is connected at its proximal end with the water-
supply, and at its distal end is attached a nozzle, the
average diameter of which varies from 2 inches to f inch.
From these a fine or coarse jet or a fan douche may be
produced. The latter is formed by placing the index-
finger of the hand holding the nozzle upon the lower bor-
der of the outlet, producing an expansion of the otherwise
solid jet into a fan-shaped stream.

The mechanical effects of the douche are derived from
atmospheric pressure, and this is of more importance in the
effects produced than the temperature.

The Scotch douche consists of alternate streams of hot
and cold water. The general cold douche is the most
powerful of all the tonics; the warm or neutral douche is
sedative; the very hot douche is frequently followed by
atonic reactions.

Rationale of the Douche. — The douche is a thermic
massage. Since the douche is a sorbefacient of pathologic
products, the French have availed themselves of its use to
aid the body to throw off an excess of uric acid, fatigue
toxins, etc.

It has been demonstrated that a rain douche of 50° F.,
under a pressure of two atmospheres, increases threefold
the work that the muscles are capable of doing, while
the Scotch douche, oscillating between 98° and 53° F.,
doubles the working capacity of the muscles. Even tepid
douches increase the working capacity of the muscles,
while a tub-bath of the same temperature is without decided
effect. The pressure under which the douche is given
adds a powerful element, which is absent in other hydriatic
procedures. The percussion and vibration affect the

48 PERSONAL HYGIENE FOR WOMEN

vasomotor system much more powerfully than any form
of still bathing.

The power and action of the heart are greatly improved
by the use of the douche, the capacity of the lungs is in-
creased, and the digestion is improved.

Brief douches of from ten to fifteen seconds generally
act better than those of longer duration. The general
condition of the patient must always be carefully studied,
and, like the Turkish bath, the douche should always be
taken under the direction of a physician, as they are also
capable of doing a great amount of harm as well as good.
The best results from the douche are obtained when it is
taken following the use of the electric-light bath.

The neutral douche is particularly applicable in cardiac
affections and in cases of high arterial tension. The
sensation afforded should not be either that of hot or cold,
and the duration from one to two minutes. The douche
for this purpose should be given with only a slight degree
of pressure, and to avoid irritation it should be directed
to either side of the spinal column. This is a sedative
application.

Contraindications for the Use of the Douche. — In all
acute inflammations and in eruptive disorders of the skin.
The cold douche is contraindicated in inflammation of the
uterus, ovaries, kidneys, stomach, liver, bowels, and
bladder, in intestinal catarrh, chronic inflammation of the
stomach, and general neuritis. It must also be avoided
in rheumatism, arteriosclerosis, cardiac insufficiency,
valvular diseases of the heart with deficient compensation,
fatty degeneration of the heart, and in cases of extreme
nervous irritability.

The Internal Use of Water. — The internal use of
water is essential to life. Water constitutes about two-
thirds of the body weight; it is found in every tissue and
organ of the body; it acts to dilute the foods so that they
can be absorbed from the digestive tract ; its presence in the
blood is essential, both to carry foods to the tissues and to
convey the waste matter away from the tissues. Its use

HYDROTHERAPY 49

in the form of a lavage is even more necessary, to keep
clean and free from impurities the mucous membrane
lining the 30 feet of the digestive canal and the tubules of
the kidneys than is the external use of water to keep
the skin in a healthy condition. Its use is also needed
to keep the blood-pressure and the heart in a normal
condition.

About 4$ pints of water are given off daily in the excreta
and exhalations; but, since about one-half of the solid
foods taken consist of water, 3 pints of water, taken daily
as such, are sufficient to counterbalance the loss.

All water for drinking purposes should be filtered. The
best method is to have a filter attached to the pipes of the
house-supply, so as to insure filtered water running from
all the spigots.

If the water is not filtered, it should be boiled for thirty
minutes. The water should be run off in the morning,
then poured into a well-kept tea-kettle and boiled. It is
then allowed to stand and become partially cooled in
covered vessels, when it is poured into large bottles —
quarts are the most convenient size; these should be stop-
pered with corks of absorbent cotton. When cool, the
bottles are placed in the refrigerator beside the ice.
Water should be boiled every morning for the twenty-
four hours. Boiling for this length of time secures the
destruction of all the germs of disease, and it is doubly
essential on the return to town in the fall, when the house
has been closed for some time; also when typhoid fever in
the neighborhood indicates the strong possibility of the
impurity of the water-supply.

The mistake should not be made of undoing the good
that has been done by boiling the water by the addition of
ice to the water when it is placed on the table. Further-
more, ice-water is so cold that it retards and interferes
with the digestive processes.

In the internal use of water the same marked difference
is caused by the different temperatures at which the
water is taken, as was seen in the external applications of

4

50 PERSONAL HYGIENE FOR WOMEN

water; but, while the temperature of the skin is about 90°
F., that of the mucous membrane lining the digestive
tract is 98.6° F. and above.

The Action of the Internal Use of Water on the Heart and
Blood. — Water improves the quality of the blood, both by
its direct action on the constituents and by the increased
elimination of waste-products. By the increase of the
volume of blood, a more energetic contraction of the heart
is caused, and the activity of all the glands of the body is
increased. There is a greater amount of oxygen absorbed
by the lungs; oxidation in the tissues is carried on more
perfectly, the result of which is that there is a diminution
or absence of the products of incomplete combustion in the
body, such as uric acid, the oxalates, etc.

By the increase of the blood-pressure, caused by drink-
ing water in sufficient quantities, the activity of the kid-
neys is increased, and this not only in the amount of urine
passed, but also of the solid constituents, which are the
waste-products, removed from the body through the
agency of the kidneys.

The Action of Water on the Digestion. — Very little water
is absorbed from the stomach ; it passes from the stomach
to the intestines, where it is absorbed. In order to ob-
tain a thorough cleansing of the stomach, and at the
same time not to cause its overdistention, not less than
\ pint of water and not more than \\ pints should be
taken at one time. The water must be taken one hour
before meals, in order to insure its removal from the stom-
ach and the proper rest of that organ before food enters
it, as it has been found by actual experiment that in a
quarter of an hour after water had been taken one-half
of the quantity remained in the stomach, but that none
remained after the lapse of half an hour. Cold water is
more quickly absorbed than warm, and the absorption
is hastened by the presence of carbonic acid, while salt of
any kind delays its absorption.

The Therapeutic Indications for the Use of Water. —
First, the temperature of the water taken must be regu-

HYDROTHERAPT 51

lated by the effect desired. Briefly stated, if the water
is taken for dyspepsia in any form, whether acute or
chronic catarrhal inflammation of the stomach or the
intestinal canal, } pint of water, just as hot as it can be
sipped with a spoon, should be taken three times a day,
one hour before each meal.

No water should be taken during the meal, and only
one glass, at a temperature of about 60° F., on its com-
pletion.

If the water is taken as a diuretic, or, in other words,
to increase the activity of the kidneys, the most of the
water should be taken in the morning on rising and the
remainder about 4 o'clock in the afternoon. Probably
the best natural waters for this purpose are the waters of
the Vosges, France. The Vittel water, "Grande Source,"
acts on the kidneys alone; where the bowels are regular
or inclined to be loose, this is the best water to use. If,
on the contrary, there is constipation or biliousness, the
"Source Salee" should be taken in connection with the
first named or alone. The " Source Sal£e " has a decided
action on the liver and is laxative.

In order to obtain a pronounced effect, at least 3 pints
of these waters should be taken daily; in some cases more
is required. Two glasses may be taken on rising in the
morning, with an interval of twenty minutes between;
the last glass must be taken one hour before breakfast.
The temperature of the water should be 50° F., which is
the temperature of the water at the springs and that of the
water when placed in bottles in the refrigerator against
the ice. In the afternoon the other two glasses may be
taken, with the same interval between.

In gastric catarrh, where there is an accumulation of
mucus or fermenting matter, with or without nausea and
vomiting, hot water alone is useful. In addition to its
action in diluting the contents of the stomach and the
intestines, and its cleansing and antiseptic effect on their
mucous membranes, the reflex effect of very hot water,
slowly sipped, is a stimulation of their muscular coats,

52 PERSONAL HYGIENE FOR WOMEN

which furthers the passage of the digested food from the
stomach into the intestines. The quantity taken must
be from \ to 1 pint, in order to obtain a thorough cleansing
and yet not to cause an overdistention of the stomach.

In acute nephritis, inflammation of the kidneys, small
quantities of very cold water, repeated at half-hourly
intervals, act as a diuretic. Care must be had, however,
not to overtax the stomach and heart by overfilling
the system with fluids.

In obesity, water-drinking is essential as a means of dis-
solving and carrying out of the body the large amount of
broken-down material which results from the increased
tissue destruction caused by exercise, hot and cold baths,
and other means employed to decrease the weight.

For constipation and biliousness two glasses of cold
water should be taken before breakfast, with an interval
of twenty minutes between, the last glass being taken
one hour before breakfast.

Contraindications. — Cold water taken into the stomach
produces more marked effects than water applied to an
equal area of the skin. The quantity of water taken is
a factor as well as the temperature. Cold-water drinking
lowers the temperature and slows the pulse, so that drink-
ing cold water must be strictly prohibited when one is
in a state of fatigue, whether perspiring or not. Feeble
persons should not drink cold water, except in very hot
weather, or just before starting out for a brisk walk in the
open air, or when about to engage in other exercise. With
the air of the room at 70° F., a woman in fair condition,
moving about making her toilet, may safely drink cold
water slowly, except when there is a feeling of chilliness.
In the latter case, the powers of reaction being diminished,
chill and internal congestion, often resulting in great
injury, may be produced. Cold-water drinking is always
prohibited when in a state of fatigue. Ice-water should
never be taken. When taken with meals, it greatly
retards digestion and may do much harm.

HYDROTHERAPY 53

Enemas. — Coloclysters. — Another valuable internal
use of water is for emptying the lower bowel, and washing
out the large bowel in cases of catarrhal inflammation.

For constipation, in which the object is to unload the
bowel as quickly as possible, 1 or 2 pints of water, at a
temperature of from 104° to 110° F., is made into a suds
by means of Castile or other good soap, and poured into
a fountain-syringe. If the enema is being given by an
attendant, the patient lies on the right side in the Sims'
position; the under leg is stretched out so that it forms
a straight line with the trunk, while the upper leg is sharply
flexed at the knee, so that the foot is opposite the knee
of the under leg; the right arm is thrown back from under
the body.

If the patient is administering the enema to herself,
the best position is the knee-chest. In this the patient
kneels on the floor, the thighs are held rigid, and while the
shoulders are brought to touch the floor, the face is turned
to one side. The position can only be taken satisfactorily
with the corsets and all tight bands around the waist
removed. In this position gravity causes the intestines
to fall upward toward the waist, and the water naturally
follows this course. In this position the water goes up
higher, and is retained longer, than when taken in the
other positions. Two pints of the soap-suds are prepared
at the proper temperature, and the patient uses as much
of this as she feels that she can retain. The water should
be retained from five to ten minutes, to get the best results.

For the purpose of washing out the large intestine more
water is used, but not more than 2 quarts should be used
for this. The position of the patient and the temperature
of the water are the same. But for this clyster, instead of
adding soap to the water, cooking salt is used, in the
proportion of 1 teaspoonful of salt to 1 pint of water.

This lavage of the intestine removes rapidly large masses
of decomposing material, swarming with microbes and
ptomains and the toxins produced by them. It also
increases the activity of the portal circulation.

54 PERSONAL HYGIENE FOR WOMEN

In cases of chronic constipation there are atony and
dilatation of the colon, and the patient always carries
about with her an enormous accumulation of fecal matter,
and lives in a state of chronic autointoxication. In this
class of cases the coloclyster should be administered daily
for from two to three weeks; if need be, so long as the
patient complains of gaseous distention and fetid flatu-
lence. After the discharge of the warm water, 1 pint of
cool water should be introduced, beginning with a tem-
perature of 85° F., and gradually decreasing this from
day to day until 70° F. is reached. This water should
be retained if possible; it acts as a tonic bath for the colon.

Care should be exercised to avoid the distention of the
colon by an excessive amount of water, and, after the
colon has been thoroughly cleansed, the amount of water
used should be decreased from day to day, until finally
only 1 pint is used. Warm water is always relaxing,
whereas cold water stimulates and tones up the bowel.
If the quantity of water used is small, the cold coloclyster
may be used indefinitely without producing constipating
effects.

Great care must be used to avoid the introduction of air
into the bowel with the water; to this end the water is
allowed to run out of the nozzle before its introduction
into the rectum. A small-sized nozzle should always be
used, and this should be lubricated with vaselin or some
other emollient, in order to prevent irritation of the mucous
membrane.

Vaginal Irrigations. — To be of any service the vaginal
douche should be taken in the horizontal position. It
may be taken on the bed, couch, or lying on the floor.
When taken on the floor, a heavy rug or steamer blanket
should be doubled four times, and two pillows are used:
the under one goes up and down for the support of the
back, while the second is used for the support of the head.
A douche-pan is, of course, indispensable. The agate pans
holding 4 quarts of water are the most serviceable. The
douche-pan is placed against the lower edge of the under

HYDROTHERAPY 55

pillow, which is protected by a bath-towel. The woman
must throw a heavy shawl or blanket over herself while
taking the douche, otherwise there is great danger of
becoming chilled, and thus doing actual harm instead of
good.

The most common and best form of syringe is the foun-
tain-syringe. This is hung about 6 feet above the bed or
floor. It should hold 4 quarts of water; this quantity of
water is necessary when the douche is given, as it most
commonly is, for pelvic inflammation. On beginning
its use, the temperature of the water must be controlled
by the sensitiveness of the patient; generally one can use
a temperature of at least 112° F., but not always; some-
times one must be content with a beginning temperature
as low as 104° F., gradually increasing the temperature by
two degrees every few days, until from 114° to 120° F. is
reached. The use of a bath thermometer is always essen-
tial to test the temperature of the water. The tempera-
ture of the douche should never go above 120° F., or
actual harm will be done.

On lying down, the lower part of the body rests on the
broad strip of the douche-pan, the nates coming over the
edge, and the clothing well pushed up, otherwise the
water will seep up the back.

The water acts as a hot poultice about the uterus and its
adnexa; it is also astringent, and greatly relieves ovarian
irritation and congestion. It is highly sedative, and is
best used at night just before retiring. In severe cases
better results will be obtained by its use twice daily. In
that case one douche must be taken in the morning, but
in cold weather it must never be taken immediately
before going out-of-doors ; there must be at least one hour
between the time of taking the douche and going out into
the cold air. Patients taking hot douches must be
warned that the pelvic viscera are much more susceptible
of chilling because of these heating procedures, and of the
necessity to counteract this tendency by the wearing of
woolen abdominal bands, both night and day.

56 PERSONAL HYGIENE FOR WOMEN

Ordinarily, plain hot water is all that is necessary
to use, but if the vaginal discharge is irritating, one tea-
spoonful of borax may be added to the pint of water; or
one teaspoonful of cooking salt; or one-half teaspoonful
of the sulphate of zinc.

Douching the Ear. — This procedure is made use of to
remove impacted ear-wax or to relieve the pain of earache.
A small fountain syringe should be used, hung not more
than 3 feet above the head. The water should have a
temperature of from 105° to 110° F. The nozzle must
be small, and have a very fine opening, and great care
must be used in its introduction not to allow the nozzle
to enter beyond the external opening of the ear. A pus-
basin or small dish may be used to protect the clothing
from getting wet. After the procedure is finished, the
ear is dried by means of a very fine handkerchief or a
little absorbent cotton.

CHAPTER III

THE CARE OF THE SKIN AND ITS APPENDAGES

The Complexion; the Action of the Bath in Health; the Proper
Time to Bathe; the Care of Wash-cloths; Cleansing the Face; Pro-
tection of the Face; the Use of So-called Cosmetics for the Face;
Facial Blemishes, Freckles, Liver Spots, Sallow Complexion, Pim-
ples, Acne, Eczema, Wrinkles, and Their Treatment; the Relation
of Diseases of the Skin to Internal Disorders.

The Hair; Dandruff; Causes and Treatment of Premature Thin-
ness of the Hair and Baldness; the Care of the Hair; Gray Hair.

The Cosmetic Care and Treatment of the Hands: Cosmetic of
the Nails; the Care of the Feet; Painful Affections of the Feet.

THE face is a complete index of the life of the individual
written large, so that he who runs may read. By looking
at the condition of the skin and the whites of the eyes we
can judge very fairly of the digestion. From the dulness
or brilliancy of the eyes we can make a very good diagnosis
of the mental condition. From the general expression of
the face we can read the kind of life that has been led by
the individual, whether of pleasure, dissipation, or sorrow.

From greatest antiquity men and women have striven
to beautify their bodies. To be indifferent to the personal
appearance is an indication of some abnormal condition in
the individual or her environment.

The Complexion. — The skin of the face is known as the
complexion, and this is the part of the skin that is most
exposed to the vicissitudes of dust and grime of the
streets or of the occupation, as well as to heat, cold, and
winds.

An ideal complexion combines the qualities of clearness,
translucency, and fineness of the outer skin, with a proper
disposition of the blood-supply.

67

58 PERSONAL HYGIENE FOR WOMEN

The beauty of the skin is evidence of good respiration,
good digestion, proper excretion by the bowels, skin, and
kidneys, good condition of the blood, and plenty of out-
door exercise.

It is now well known that the skin, as well as other parts
of the body, depends for its integrity upon the general
nervous system. Disturbance anywhere in the body acts
upon the central nervous system. A simple case of indi-
gestion often manifests itself over considerable areas of the
skin.

It cannot be too earnestly impressed on the reader that
beauty is entirely dependent on the health. It will
readily be seen that no external applications can produce
such qualities as fineness of texture, translucency, and
delicate play of coloring produced by the contraction
and dilatation of the blood-vessels.

The natural order in which to consider the skin will be
first as subservient to health, and then as it is conducive
to beauty.

The Action of the Bath in Health. — Not only in the
art of pleasing, but in the maintenance of health, neatness
of person must be carried to perfection. By the use of
friction, soap and water, the scarf-skin becomes more and
more constantly renewed by the layers underneath it.
It becomes softer, more pliant, and finer than satin in
appearance and texture. Besides this, as has already
been shown, bathing has upon the corium or true skin,
and thence upon the general system, a revitalizing in-
fluence. Combined with the proper kinds of soap,
avoiding the use of irritating ones, bathing removes from
the skin all effete oily matters, scales of the scarf-skin,
crusts, the saline matters excreted by the perspiration,
dust of all kinds, soot, particularly that from the clothing,
and so forth.

Caustic soaps and borax in excess may remove the oil
in so great quantities as to be detrimental to the skin.

Within twenty-four hours the skin, especially those

PLATE I

THE CARE OF THE SKIN AND ITS APPENDAGES 59

parts which are covered, becomes vested with a pellicle
of impurities, which, when allowed to remain, become
thicker every day, and may produce injurious effects by
obstructing the excretory openings and affording lodge-
ment for disease. The effects would be felt not only in the
skin, but in the whole organism. The skin when not
cleansed will be irritated chemically and mechanically.

The Proper Time to Bathe. — This depends on the
nature of the bath to be taken, the strength of the woman,
the temperature of the room, and the season of the year.

To repeat, a cold bath of any description must never
be taken unless the body has a decided sensation of
warmth. In winter, if she will drink a glass of hot water
before rising and has a warm room, the woman in average
health may take a cold sponge bath. But the body must
be very gradually trained to the application of cold, just as
it is to vigorous muscular exercise. For the woman who
has never in her life taken a cold bath of any sort, except
in midsummer, to begin a heroic treatment with cold
baths in winter would be utter folly, which might easily be
the cause of pneumonia and even of death. The time to
begin a systematic use of cold water is in summer, con-
tinued through the autumn, and by the time midwinter
has arrived, the system has become so toned up that noth-
ing but good can result.

If the woman is not very strong, she had better begin
with the cold ablutions, just to the waist, on rising in the
morning. These must always be followed by a vigorous
toweling and friction. In case of inflammation of the
kidneys or pelvic viscera, cold applications to the abdomen
should be avoided, as they are badly borne.

If the woman is anemic, has a poor circulation, or is con-
scious of her heart, she will feel at her best in the after-
noon. In that case, after a cup of hot bouillon, taken
on rising from her siesta, she may take a quick hot scrub,
followed by a cold shower. This is much more invigorat-
ing than the cold ablution, and the reaction at that time
of the day is more vigorous than in the early morning.

60 PERSONAL HYGIENE FOR WOMEN

From the simple ablution, the next step in training
would be the cold wet sheet. It is impossible to take
this without an attendant, but a good maid may readily
be taught to give the necessary rubbing. Ordinarily,
this will be enough to attempt in one winter.

A strong woman, who has always been accustomed to
taking cold baths, may all the year round, except just
before, during, and immediately after the menstrual period,
take a cold dip on rising in the morning. It must be
literally a quick dip in a tubful of cold water, from 65°
to 55° F., or, if she is sufficiently strong to stay in the tub
longer, there must be a constant brisk friction kept up
while in the water.

It is permitted only a woman in good health, with a
strong heart and normal kidneys, to get into a tub of
cold water, take a cold plunge, or attempt sea-bathing.

For the woman who is a semi-invalid, the only time
allowable for a cold tonic bath is in the afternoon.

In cold weather the shower, like all other forms of baths,
must be taken in a warm room. The shower bath can be
taken every day to the greatest possible advantage. An
ideal way is to rest for half an hour on coming home in the
afternoon; to sleep, if possible, then take a quick scrub,
and follow it first by the hot shower of 100° to 104° F.,
and finish with the cold shower. A brisk rubbing should
be kept up until the skin is in a good healthy glow.
This bath is followed by a feeling of great exhilaration,
and it gives a beautiful glow to the face and skin. It
removes the tired feeling of the day's work, and leaves
one feeling greatly refreshed for the evening. A daily
ablution or a daily shower, with friction, will not cause an
undue removal of the oil of the skin. All cold baths, when
given in suitable cases, tone up the system to resist dis-
ease, and are the best preventives against ordinary colds
and sore throat.

A hot tub-bath is best taken at night just before retir-
ing. In winter it must never be taken immediately before

THE CARE OF THE SKIN AND ITS APPENDAGES 61

going out-of-doors, because the pores of the skin are more
or less open and there is great danger of chilling. A hot
tub-bath, remaining in the bath for some minutes, should
not be taken more than twice a week, as it is too debilitat-
ing, and a prolonged stay in the hot water causes an actual
loss of flesh.

A woman may take a warm sponge bath in a warm room
at any time of the month, but during the menstrual period
she must, under no consideration, take a cold tub-bath or
even a cold sponge-bath, since this would be apt to cause
a chill of the surface of the body and a congestion, if not
an actual inflammation, of the pelvic organs.

No bath should be taken within two hours after eating,
as the bath draws the blood from the stomach toward the
surface of the body and so interferes with digestion.

The Care of Wash-cloths. — After using each time, the
wash-cloth must be thoroughly washed, well rinsed, and
hung up to dry. But this is not sufficient: once every
week all wash-cloths must be sent to the laundry to be
boiled, thus insuring the destroying of any germs that may
lurk in the cloth. If a woman has any kind of skin disease,
it is quite possible for her to reinfect herself after the dis-
ease has apparently become cured. Further, each mem-
ber of the family should have her own individual towels,
soap, and wash-cloths. Aside from all sanitary questions,
in a matter so intimate as the bath, there is something
repulsive in the thought of having your toilet articles
used by any one else.

A pure Castile soap is one of the best that can be used.
All cheap scented soaps should be avoided, as they are
apt to contain impure materials that will actually injure
the skin. If the skin is rough, rubbing it with a good
sand-soap, and rubbing the same on the flesh-brush, will
remove many of the scales and leave the skin much
smoother and softer. Medicated soaps should never be
used except by the direction of a physician.

Cleansing the Face. — The face should be well washed

62 PERSONAL HYGIENE FOR WOMEN

twice a day with cool or cold water, but the temperature
of the water should not be below 60° F. The degree of
coolness must be determined by the feelings and judg-
ment of the individual. If the face were washed with very
hot or very cold water, and then exposed to the cold air,
the skin would become rough and chapped. The water
should be soft. To soften hard water, put 1 pound of
bran into a muslin bag, place in 4 quarts of water, and boil
for fifteen minutes. Add enough of this bran water to the
bath to make the water milky.

A soft, woven face towel, kept for the face and neck
only, should be used with a moderate degree of friction.
Great care must be used to wipe the skin thoroughly
dry.

It is a question whether the daily use of soap on the
face is advisable; for the healthy skin it is not essential
and may prove very injurious. Soap should never be
used on the face in winter just before going out-of-doors,
as this would cause a roughening of the skin. When the
hot tub-bath is taken, the face should be well washed with
soap and hot water, plenty of friction being applied by
means of the face towel, after which the face is thoroughly
rinsed with pure water. This will open the pores qf the
skin, and should be followed by the use of cold water,
which has a stimulant action on the blood-vessels and
improves the circulation in the skin. It also improves the
tone of the elastic fibers in the skin and tends to delay the
appearance of wrinkles.

If there is any tendency to dryness of the skin, a good
cold cream should be well rubbed in just after bathing the
face. The cream must be a good quality and perfectly
fresh, as a rancid cream is irritating to the skin. Only
so much of the cream should be applied as will be absorbed
by the skin. When the skin is very thin, and there has
been loss of subcutaneous fat due to ill health or other
cause, the systematic application of cream in this manner
aids in the nutrition of the skin; and, when applied to the

THE CARE OF THE SKIN AND ITS APPENDAGES 63

neck with good massage, is a great protection against sore
throat due to exposure to drafts and cold.

Protection of the Face. — The cold winds of winter
cause a dryness of the uncovered skin of the face and lips,
which often leads to a painful chapping, and, in the case
of the lips, small fissures may be produced. In addition to
the use of cold cream, a good rice powder may be applied,
which serves as a further protection to the skin.

In very cold weather a veil should be worn to protect the
face from the cold and winds. In summer a parasol should
always be carried, to protect the eyes and brain as well as
the face from the hot rays of the sun.

The Use of So-called Cosmetics for the Face. —
All skin specialists, and these are in the very best position
to judge of the great amount of harm that is done, say
emphatically that the use of face lotions and "paints"
can only work the lasting injury of the complexion.
They may assist in hiding the defects of nature, but they
frequently contribute to increase these defects. Many
of them merely fill up the pores of the skin and give it a
pasty look. Numerous cases of eczema and other dis-
eases have followed the use of paints. Of the advertised
cosmetics, many are not only worthless, but actually in-
jurious.

Certain applications to the skin of the face are permis-
sible and beneficial. "Virgin milk," which is a milky-
looking mixture, composed of the tincture of benzoin and
rose-water, renders the skin soft, and is said to prevent the
formation of freckles. If the skin is dry, glycerin may
be added to this. The formula for this mixture is as
follows : Take of the tincture of benzoin and glycerin each
1 ounce, mix well, and then add 2 ounces of rose-water.
This should be applied by the fingers, just after the face
is washed. Pure glycerin is irritating, and should never
be applied to the face without dilution.

The various good preparations of rice and talcum pow-
der on the market are perfectly harmless, and, if there is a

64 PERSONAL HYGIENE FOR WOMEN

tendency to greasiness or shininess of the skin, the use of
these is essential from an esthetic point of view. In
case of greasiness a little calcined magnesia may be used.
In hot weather the use of face powder is very refreshing,
and in the hot climates it is used for this purpose to a very
striking extent. But the true cosmetics, and the only
ones that can procure and keep a beautiful complexion, are
plenty of exercise in the open air, attention to the diet,
to the daily evacuation of the bowels, to the condition of
the kidneys, to baths, and to proper dress.

Facial Blemishes. — Among the most common facial
blemishes are freckles, liver spots, a sallow complexion,
pimples, acne, eczema, superfluous hairs, and wrinkles.

Freckles. — These are brownish or yellowish pigmentary
spots, varying from the size of a pin-head to that of a pea.
They occur on the face and the backs of the hands.
They consist of a circumscribed deposit of pigment;
not much is known about their origin. The pigment is
situated in the deep layers of the epidermis, and, in order
to remove the freckles, it is necessary to use something
capable of producing desquamation. As a rule, if left
alone, they will gradually disappear.

Liver Spots. — The so-called liver spots are irregular
patches of a brownish color, which appear most frequently
on the face, neck, chest, back, arms, and hands. If not
caused by disorders of the liver and digestion, they are cer-
tainly aggravated by them. They are not only unsightly
blemishes on the skin, but sometimes cause great nervous-
ness by the intense itching which accompanies them.

Sallow Complexion. — This is generally caused by dis-
orders of the liver, and is most frequently met with in hot
countries. It is seen in chronic dyspeptics, and, indeed,
in most forms of chronic disease, and is not only a symp-
tom of the disordered bodily state, but a cause of its per-
petuation. This appearance of the skin is due to the
accumulation of effete matters in it and to its impaired
nutrition, and this state exists not only in the skin, but in
the whole body.

THE CARE OP THE SKIN AND ITS APPENDAGES 65

Pimples, or Blackheads, and Acne. — These are affections
of youth, and are generally seen together, the last-named
being simply a second stage of the first. Pimples, or
blackheads, appear as small elevations in the skin, with a
small black point in the center. The cause of the pimple
is the alteration in the quality of the sebum, the oily
secretion, which becomes and remains a hard mass in the
excretory ducts of the sebaceous glands and plugs up its
external opening. The dust of the air becomes mixed
with the fat, and thus makes a black point. When the
ducts cannot get rid of the sebum, they become stopped up,
and in consequence become swollen. This irritation
spreads to the adjacent tissues, and so inflammation arises.
Finally, the contents of the duct undergo degeneration,
suppuration occurs, and the contents become mixed with
pus, small abscesses result at various depths in the skin,
and so require more or less time to break out.

This inflammatory condition of the sebaceous glands
with their ducts is apt to become chronic and may
prove an obstinate affection. It occurs most commonly
about the face, on the back between the shoulders, or on
the chest. The skin is rough to the touch, the ducts of the
sebaceous glands are enlarged, and the skin is greasy.

Eczema. — This is the most common of all skin affec-
tions. It is a non-contagious, inflammatory disease of the
skin, sometimes acute, but more often chronic, attended
with itching and desquamation or loss of cuticle. With the
itching may be a feeling of heat and tension in the part.

Eczema is a local disease, brought about by a local
irritation in the skin; but, in addition to this, there is
generally a predisposing cause, as some disorders of the
digestive tract, a bad condition of the blood, and so forth.
The skin, like other organs of the body, depends on the
whole system for its nutrition. WTien this nutrition is not
sufficient, the skin appears pale, of a peculiar color, and is
easily taken up in folds, an evidence of poor nutrition of
the skin. When the skin is not properly nourished,
every slight irritation is liable to produce eczema.
5

66! PERSONAL HYGIENE FOR WOMEN

Treatment of Liver Spots, Sallow Complexion,
Pimples, Acne, and Eczema. — First, the general treat-
ment. While every case of skin disease must be treated
according to the peculiarities of that patient's case, still,
there are general rules which should be followed in the
treatment of all cases, and first in importance comes at-
tention to the bowels. There must be procured, by some
means or other, a free daily evacuation. A hard, consti-
pated movement is not sufficient. Fruits and vegetables
are both laxatives and the very best. Water is also a
laxative, and 3 pints a day should be taken, not only for
the laxative effects, but also because this amount is needed
to keep the kidneys properly flushed. Of the simple
medicinal laxatives, one of the best is the effervescing
granules of the phosphate of soda; the dose is from one
teaspoonful to one tablespoonful, to be taken in a glass
of cold water on rising in the morning. Sometimes pa-
tients who are troubled with gas cannot take anything
which effervesces; in that case, the plain phosphate of
soda may be substituted.

Next in importance to the attention to the bowels
comes the diet. All articles of diet must be easily di-
gested, while at the same time they are nourishing.
Cereals, pies, pastry, fried foods, hot breads, rich gravies,
rich salads, pork, and veal must be excluded from the
bill of fare.

Fresh meat must be eaten by a woman in health at least
once a day, and young girls need it twice a day. This
should be supplemented with eggs and milk, fresh vege-
tables, and not an excess of stale bread or toast. The
latter is constipating. Tea and coffee should both be
avoided.

A glass of hot water, taken one hour before meals,
will do much to rid the stomach of mucus and put it in a
good condition for the digestion of the food.

For the congestion of the liver, which is so often at the
bottom of these disorders, it is generally necessary to
consult a physician.

THE CARE OF THE SKIN AND ITS APPENDAGES 67

Pure air, associated with the proper kinds of exercise,
promotes the functions of the skin, assists in keeping the
blood in good condition, increases the vigor, keeps the com-
plexion clear and increases its beauty; while, on the other
hand, a sedentary life in a confined air produces a pallid and
frequently a blotched skin, with headache and dyspepsia.

Steaming the Face. — It seems that the blood-vessels of
the skin are much better able to absorb vapor than water.
The vapor penetrates and softens the epidermis much
better than the simple application of water would. The
increased secretion from the skin which is thus caused
is beneficial. After using the vapor bath the outer layers
of the epidermis peel off and the complexion is improved
by the substitution of new pigment. The absorption of
the moisture also causes a roundness of the skin and a
filling out of the wrinkles. Generally, vapor baths can
be used in those cases of skin diseases where the skin is
rough and dry. Next in importance to the vapor bath
is steaming the face. Bathing the face with very hot
water is also recommended.

Massage of the Skin. — Where the complexion is sallow,
or there is a tendency to pimples or blotches, massage of
the skin of the face will do much to improve the circulation.

The massage is most effective when it follows steaming
or washing the face in hot water. The tips of the fingers
should be dipped in cold cream, and then, pressure being
exerted by them, the skin of the forehead should be
deeply stroked from the middle line out over the temples.
The nose should be stroked from the bridge outward and
downward. The skin of the cheeks should be pinched up
and rolled between the fingers and thumb. All these
movements facilitate the emptying of the follicles.

Never use an ointment on the face that contains vaselin
or lanolin, but particularly the former, as they are both
apt to produce a growth of hair, but these preparations
are excellent to increase the growth of the eyebrows.

Wrinkles. — In very many cases wrinkles are the result
of habit of expression, as in scowling; or an expression of

68 PERSONAL HYGIENE FOR WOMEN

dejection, when the angles of the mouth curve downward,
and so forth.

There are twenty-eight muscles about the mouth.
Since all these muscles are developed by use, the mouth
comes to assume the expression given to it by the thoughts
of the individual. The figurative expression, " down at
the mouth," comes to be literally true, and the angles of
the mouth are seen to be habitually drooping, until at
last this is the fixed expression of the face. A healthy
frame of mind is the only means to keep the face from

Fig. 3. — Muscles of the right side of the head and neck.

being converted into a map of wrinkles and drooping
angles at the mouth.

The wrinkles are not, as a rule, caused by any trouble
in the skin itself, but in the underlying muscles, the
tissues of which have become relaxed or weakened. The
circulation of the parts may be stimulated, and so in-
creased nourishment be secured by deep massage of the
muscles, and, at the same time, the use of a good cold
cream will aid in the nourishment of the skin.

The face should first be washed and steamed according
to the directions already given. The massage of the face

THE CARE OF THE SKIN AND ITS APPENDAGES 69

should always be carried out in a systematic manner.
Begin with the forehead. Stroke with the two thumbs
over the forehead, starting near the eyebrows, and work
out toward the roots of the hair. In the second move-
ment one hand is used to stretch the part worked upon,
while deep friction is made with the tips of the fingers of
the other hand.

For wrinkles about the eyes, stroke with the tips of the
fingers, over and below the eyes, from the nose toward the
temples. Great care must be taken not to apply too much
cold cream about the eyes, lest some of it should get into
them. For the removal of the "crow's feet" at the outer
angle of the eye stretch the part with the thumb and finger
of one hand, and perform friction with the tips of the fingers
of the other hand.

To remove the lines that run from the corners of the nose
to the angles of the mouth, stroke with both hands, one on
each side of the face, beginning at the center and lower
part, and stroke upward toward the temples. This up-
ward motion counteracts the drawn and pulled-down
condition of the face.

For the cheeks, use both friction and deep kneading;
pick up the muscles between the thumb and finger.

To remove wrinkles under the chin and a double chin,
begin at the middle line, and with both hands make deep
pressure upward and outward. To remove superfluous
fat, make deep friction with the tips of the fingers. In
the latter case, only use enough cocoa-butter on the
fingers to prevent the friction against the skin. The
benzoin preparations, already given, will help to contract
the tissues.

A cold cream which is a good skin food is the follow-
ing: Take of the oil of sweet almonds, 2 ounces; of sper-
maceti, { ounce; of white wax, $ ounce; and of rose-water,
i ounce. Melt together at a moderate heat, the oil,
spermaceti, and wax, then gradually add the rose-water;
stir the mixture briskly and constantly until it is cool,
and continue the stirring until it has become uniformly

70 PERSONAL HYGIENE FOR WOMEN

soft and creamy. The Dover egg-beater will give it the
desired creamy appearance.

The Hair. — From an esthetic point of view, a head of
luxuriant hair is a matter of prime importance to the
woman.

The hairs are peculiar modifications of the epidermis.
The hair folh'cle is a cylindric-shaped depression of the
skin, whose funnel-shaped mouth opens on the free sur-
face. Immediately below this is a constriction, called the
neck, which is the narrowest part of the follicle; the duct
of the sebaceous gland, which supplies the hair with oil,
opens at this point. The base of the follicle is bulb-shaped,
to accommodate the hair-papilla and the hair-bulb. The
hair-papilla contains the blood and nerve supply for the
hair. When a hair is plucked or falls out, a new hair grows
from the hair-papilla.

According to Pincus, the life of a hair ranges from two
to six years, after which it falls out, to be replaced by a
new one. In this way about fifty or sixty hairs are nor-
mally shed every day.

In order to have thick, luxuriant, silky hair great atten-
tion must be paid to the condition of the scalp, since it is
the scalp which contains the blood-vessels that nourish
the hair. The scalp should be thick and pliable and move
freely over the bones of the skull. If the scalp is drawn
tightly over the bones of the skull, it tends to constrict
the blood-vessels, and so lessen the supply of blood to the
scalp and cause atrophy of the roots of the hair from pres-
sure.

The hair has a great tendency to accumulate dirt. It
catches the dust flying in the air, and also retains the secre-
tion of fat and the desquamated epithelium of the scalp
and the products of perspiration.

The two chief causes of the premature thinness of the
hair are a deficient circulation of blood in the scalp and
dandruff, and it is said that dandruff causes the loss of
hair in 70 per cent, of all cases.

Dandruff. — The last few years has witnessed a revolu-

THE CARE OF THE SKIN AND ITS APPENDAGES 71

tion in the views of the skin specialists in regard to the
cause of dandruff. Previous to that time it was consid-
ered as simply a collection of epithelial scales mixed with
more or less oily matter. Now, following the investiga-
tions that were first instituted by Unna, dandruff is con-
sidered as a symptom of a parasitic disease of the scalp,
called seborrheic eczema. Sabouraud believes that the
same parasite that produces seborrhea causes the loss of
hair. It is believed that the parasite grows down into the
hair follicle, between its walk and the hair.

Seborrheic eczema is a chronic desquamative inflam-
mation of the scalp of bacterial origin. It is divided into
two stages: the first may last from one to seven years; it
is attended with more or less dandruff in the form of scales
and dryness of the hair; or the dandruff may unite with
the oil, producing fatty crusts which are removed with
difficulty. This is followed by the second stage, in which
the hair falls out.

Symptoms of Seborrheic Eczema. — In the dry form of the
disease, in which there is a scaling of the scalp, the hair is
dry and unmanageable, the head itches, especially when
the patient sits under a light or becomes overheated.
There is a more or less constant falling of the scales upon
the clothes. The scalp looks pale, and will be found
covered with fine grayish or yellowish, readily detachable
scales. Sometimes there is more or less redness of the
scalp. This is the mildest grade of the disease.

That dandruff is contagious has been proved by experi-
ment, experience, and treatment. Lassar and Bishop
made a pomade of the scales taken from the head of a
student who was suffering from this disease, and rubbed it
into the backs of guinea-pigs, which caused the same dis-
ease in them, and falling out of the hair.

Cases have been reported in which husband and wife
have contracted dandruff after marriage, he or she having
been free before.

The drugs that are most efficacious in the cure of
seborrhea are active antiparasitics.

72 PERSONAL HYGIENE FOR WOMEN

Causes of Seborrheic Eczema. — The general causes are
debility, constipation, and anything which undermines the
general health. The local causes are lack of cleanliness of
the scalp, and using combs or hair-brushes which have
been used on the scalps of persons who were suffering
from this disease.

In most families will be found one or more mem-
bers who possess enough seborrheic infection to cause
the spread of the disease throughout the rest of the
household.

Causes and Treatment of Premature Thinness of
the Hair and Baldness. — It has already been stated that
70 per cent, of these cases were caused by seborrheic
eczema. Among other causes may be mentioned a pro-
gressive tightening of the scalp upon the skull, the scalp
having lost the cushion of fat that is under it in early life ;
insufficient or improper care of the scalp ; daily sousing of
the head in cold water, combined with improper drying
of the hair afterward; sweating of the head; constant
mental strain, either on account of intellectual work or
worry; wearing stiff, unyielding hats; gout, and all diseases
which lower the general nutrition.

The chief treatment is by prophylaxis, or using pre-
ventive measures to insure the healthy condition of the
scalp. And first and most important of these is cleanli-
ness. Because of the great length of time which it takes
to dry long, thick hair, many women do not wash the scalp
often enough. In the healthy state of the scalp it should
be washed at least once a month.

The Care of the Hair. — There is never any danger of
shampooing the healthy scalp too frequently. The oil in
the scalp is not removed by washing, but is, on the con-
trary, always increased through the improvement in the
circulation. Where there is much dandruff, or if the hair
has begun to fall out prematurely, owing to long neglect
or following an illness, it is well to begin by washing the
hair two or three times a week, and then gradually in-
crease the interval to every two or three weeks.

THE CARE OF THE SKIN AND ITS APPENDAGES 73

Borax in the water cleanses the scalp well, but its con-
tinuous use is injurious; the same may be said of am-
monia water.

One of the best shampoos is the tincture of green soap.
If this cannot be obtained, take of the official green soap
2 ounces, and of alcohol, 1 ounce; mix well, and make
shampoo. One ounce of the tincture or its substitute
should be diluted with twice as much water and applied
to the scalp with the tips of the fingers. When enough of
the shampoo has been used, add sufficient water to make
a good lather. This must be thoroughly rubbed into the
scalp, going over the whole systematically. After the
scalp is cleansed, the soap must be well rinsed out of
the hair. This may require many changes of the water,
but it is most important. Dry the hair with hot towels,
the process being completed by a radiator or stove oven.
Fanning the hair will hasten the process very consider-
ably. The hair should then be loosely braided and a hot
towel wound around the head to insure perfect dryness
of the hair and as a prevention against taking cold.
One hour is sufficient for the entire procedure. In winter
the hair should be washed just before retiring.

Brushing the Hair. — Brushing increases the growth of
the hair by stimulating the circulation in the scalp and by
removing the dandruff. To be effective, the hair should
be well brushed at least once a day, when there must be a
deep brushing of the entire scalp. The bristles of the
brush must be stiff enough to warm, but not to scratch,
the scalp. Brushing and massage remove any loose hairs
that are ready to fall, but they will soon be replaced by
new vigorous ones.

Combing simply disentangles the hair. The teeth of
the comb must be far apart and have rounded ends. In
no case should a fine-toothed comb be used. It tears out
the hair, and often causes an irritation of the scalp which
leads to disease.

From what has been said, it will be seen that every
member of the family should have a brush and comb for

74 PERSONAL HYGIENE FOR WOMEN

her own exclusive use, and that no one should allow a
public brush or comb to be used on her head.

The brush and comb must be washed once a week in
water containing a little ammonia; they must be well
rinsed out hi pure water; the brush should be dried
quickly, with the bristles down. If the brush and comb
are not cleaned sufficiently often, the scales of dandruff
would be sufficient to reinfect the scalp.

Massage of the Scalp. — The scalp should be thoroughly
massaged every night. Grasp the scalp with both hands
laterally, as well as anteroposteriorly, and with some press-
ure loosen the tissues from the underlying parts and try
to raise it in folds, or it may be pinched with the forefingers,
producing some vascular flux and a sense of warmth.

If the scalp is too dry, nothing is better than pure
vaselin, though some persons prefer olive oil, applied by
means of a dropper. The yolks of eggs beaten up with
lime-water make an elegant shampoo.

Dressing the Hair. — Dragging or twisting the hair from
its natural direction, pulling it into constrained or arti-
ficial positions, and even twisting the hair very tightly
is injurious to it.

The curling iron acts by abstracting more moisture on
one side of the hair than on the other. The stronger the
hair, the more easily it will curl, and the longer it will stay
curled. The daily use of a hot iron, notwithstanding
the greatest care, will in a short time prove injurious;
the hair is apt to become thin and fall out. Its growth
is interfered with. The use of kid curlers is much less
injurious, but even here the tight twisting of the hair
around the kids is said to be harmful.

Shell hair-pins are the best for the hair. If steel ones
are used, the points must be smooth and the pins kept
in good condition.

When the hair is dressed for the night, after the scalp
has been brushed and massaged, it should . be loosely
braided and left hanging down.

Cutting the hair 1 inch, every two or three months, is

THE CARE OF THE SKIN AND ITS APPENDAGES 75

said to promote the growth of the hair and prevent its
splitting. It does not increase the number of hairs.

There is no truth in the assertion that the hair is a hol-
low tube, which allows the escape of oil, and that if the
ends are sealed by singeing much good will result.

Gray Hair. — Grayness of the hair may be either
premature or physiologic. When the grayness is due to
some temporary cause, as anxiety or some diseased state,
the process may cease completely on the removal of the
cause. Usually the whitening is permanent. The gray-
ness of the hair is caused by obscure changes in the
nutrition of the hair-papilla, which interfere with the
production of the pigment. As a rule, the hair whitens
first on the temples, then on the top of the head.

The hair first turns gray at its root. The grayness is
due to the loss of pigment. Prolonged residence in either
a very cold or a very hot climate will cause the hair to
turn gray.

A yellowish tinge of the hair is sometimes seen in pa-
tients with jaundice, or gray hair may owe its dull yellow
color to the tint of dry albumin of which it is composed.
The glitter of steel-gray or silver-white hair is due to the
high refractive power of the minute air-bubbles that lie
in the substance of the hair.

Treatment. — The color cannot be restored to gray hair.
The roots of the hair are embedded in the hair follicles,
and cannot be reached by any fluids applied to the scalp.
Not only is the use of hair-dyes to be deprecated as an
exhibition of poor taste, which happily is going out of
fashion, but the use of hair-dyes is extremely dangerous.
Cases are being constantly reported by physicians, where
the use of these supposedly simple vegetable hair-dyes
has been followed by very serious and extensive derma-
titis of the face, neck, and shoulders.

Gray hair is really very beautiful when it is of silvery
whiteness, and very ugly when it is of a yellowish-white
color. It must be treated with much greater care, in

76 PERSONAL HYGIENE FOR WOMEN

order to preserve its silvery whiteness, than was neces-
sary to keep the hair in good condition before it lost its
coloring pigment. It should never be wet, except when
it is shampooed. For this reason, instead of using hair-
curlers, crimping pins should be used. In this way the
hair is waved quite as well and the use of water is avoided.

The Cosmetic Care and Treatment of the Hands. —
Of all the members of the body, next to the face, the
hands have the most expression, and serve as an index
of character and refinement.

Not only should the most scrupulous attention be given
to having clean hands and nails, but every precaution
should be taken to keep the skin soft and the nails care-
fully manicured. This is quite possible for the housewife,
simply by wearing rubber gloves while she does her work.
It preserves the fine sense of touch in the fingers, which aids
in sewing and embroidery, at the same time that it adds
much to the beauty of the hands.

Chapped Hands. — To prevent chapping of the hands
in cold weather heavy gloves must be worn or a muff
carried. Another aid in the prevention of the skin of the
hands from becoming rough and chapped, and the best
means for curing them if this has occurred, is by the
use of a good cold cream at night, just before retiring.
The cold cream should be well rubbed in the skin, espe-
cially about the finger-nails, and after this talcum powder
be dusted over. This forms a thick covering for the hands,
the talcum powder prevents the cream from being rubbed
off on the bed-clothes, and, on getting up in the morning,
the skin will be found to be soft. Only in case the hands
are very badly chapped should old kid gloves be worn at
night.

Cosmetic of the Nails. — The physiologic function of the
nails is to protect the tips of the fingers against pressure
and to give them a firm support; this increases the delicacy
of the tactile sensations.

The nails should be slightly curved from side to side, of

THE CARE OF THE SKIN AND ITS APPENDAGES 77

a light rose color, and smooth surface. The lunula shduld
be visible at the root of the nail. Brittleness of the nails
is a defect, which causes them to tear easily; it is generally
due to the condition of the general health.

There is a natural tendency for the dirt to accumulate
on the under surface of the nail, between it and the finger.
This is not only unsightly, but it is often the cause of
actual danger, as this forms a lodgment for the germs of
disease^. Not only is it necessary for doctors and nurses
to give the most scrupulous attention to the care of the
nails, but, when we learn that one cook has been the cause
of spreading typhoid fever through a number of families,
in her itinerary in going from place to place, we must be
impressed with the necessity of more careful oversight
being given to the hands of domestics and housewives
who prepare the food.

For the same reason, it is self-evident that the hands
should always be washed immediately before going to the
table, and cleaning the nails is always a finishing touch in
the washing of the hands.

For the purpose of cleansing the nails, an orange stick
or nail-file should be used, and never the point of the scis-
sors or the blade of a knife, for either of these causes a
roughening of the under surface of the nails, whereby
the lodgment of dirt becomes only the more securely
fixed. After the use of the nail-file, the nail-brush should
be used, followed again by the use of the file or stick.
If there is a tendency to a roughening of the skin under
the nail, it can be obviated by the use of cold cream at
night. Just before retiring, the fingers should be dipped
into cold cream, and let the tips take up just as much as
they will retain, and after this dipped into talcum powder.

The small rim of epidermis which laps over the nail
should be gently shoved back with the orange stick every
day. This skin, when torn, forms the so-called hang-
nails, by which infection easily enters the system; it
may give rise to felons or even to general blood-poison-
ing.

78 PERSONAL HYGIENE FOR WOMEN

The Care of the Feet. — In the care of the feet it must
be remembered that the leather of the closely fitting boot
allows very little ventilation, and so more attention must
be paid to the airing of the feet as well as to their bathing.
The feet should be bathed twice daily.

On making the toilet for the evening dinner both shoes
and stockings should be changed, the stockings hung up hi
the room, and the shoes left out to air and dry, instead of
being stuffed into the shoe-bag, to remain there until
the next morning.

An alcohol rub will be found very refreshing to weary
feet. For profuse perspiration of the feet, boric acid or
talcum powder may be used, dusting the powder over the
feet both night and morning.

Ingrowing Toe-nails. — The common causes of ingrowing
toe-nails are improper foot-wear and an improper method
of cutting the nails. If the nail is cut too short, especially
at the angles, while at the same time the shoe is too short
or too narrow, the skin of the toe is forced over the nail,
so that it necessarily happens that, by the further growth
of the nail, the flesh of the toe is pushed still further over,
until a point is reached where inflammation is set up.
There is excruciating pain, which may be accompanied by
the formation of a small tumor, which forms pus and may
go on to granulation — the so-called "proud flesh."

The preventive measures of the trouble are, first, in
cutting of the nails. The toe-nail should be cut in a con-
cave form, the outer angle projecting beyond the toe.
If there is a tendency for the flesh to grow over the nail,
the flesh should be pushed back from the nail, and fast-
ened in this position with a strip of oxid of zinc plaster,
and a gauze packing should be inserted under the nail-
edge. A saturated solution of boric acid serves as an
antiseptic dressing. It is often possible to cut off the
projecting nail, and, by the use of the boric acid dressing,
the trouble disappears in a few days. Attention should
always be given to the toe-nails when bathing.

Corns. — There are two varieties of corns; both are very

79

painful. Soft corns come between the toes, and unless
absorbent cotton is inserted to prevent the rubbing of the
toes together, a second corn appears on the opposing sur-
face of the adjoining toe. A very effective remedy for
this is the application of blue-stone, or sulphate of copper,
to the corn. The stone is moistened in water and then
applied thoroughly to the corn; absorbent cotton should be
placed between the toes. In very severe cases it may be
necessary to stay off the feet for a few days and keep the
foot upon a chair.

Hard corns must be cut down with the greatest care.
It should be done directly after the bath, so as to have the
skin in as nearly an aseptic condition as possible. A small
scalpel, composed entirely of steel, should be kept for this
purpose. It must be thoroughly cleaned after it is used,
and just before its use be sterilized by boiling for five
minutes. The reasons for these precautions are the pos-
sibility of cutting into the flesh and setting up blood-
poisoning by the entrance of germs into the wound.

CHAPTER IV

THE DIGESTIVE SYSTEM: GENERAL PRINCIPLES
IN HUMAN NUTRITION AND DIETETICS

The Digestive Tract; Care of the Mouth and Teeth; Controlling
Factors of Digestion; Psychic Aspect of Digestion; Importance of
Mechanical Factors; Chemical Changes of Food in the Stomach;
Intestinal Digestion; Metabolism; Constipation and its Treatment.

The Amount of Food Required; the Classification of Foods;
Standard Dietaries; Maintenance Diet; Relations of Diet to Various
Conditions of Life; Practical Facts for Guidance; Dietary in the
Tropics; Food Economics; Table of Food Values.

The Physiologic Action of Moderate Doses of Alcohol; the Effect
of Alcohol on the Muscular System; the Effect of Alcohol on the
Nervous System.

"If there is anything new of importance in the practice of medicine
it is this modern work in nutrition." — Mendel, 1914.

THE activities of animals are carried on by a certain
expenditure of energy which is set free as the result of a
chemical breaking down of the living tissues of the body.
In order to maintain the equilibrium of the body this
waste must be replaced by new material which is taken in
the shape of food, drink, and oxygen.

Digestion is the term applied to those changes in the
food-stuffs which precede absorption; it is a refining process
which separates the useless from the useful, and further
prepares the latter to be used as building-stones for the
repair of organs and tissues and to furnish fuel to supply
the motor energy of the body.

In the human body the digestive processes are brought
about by mechanical disintegration; by the action on the
food-stuffs of acid and alkaline fluids; by changes produced
by active substances called enzymes; and, lastly, decom-
position is produced by the growth of microorganisms.

The digestive tract, or alimentary canal, begins at the

80

THE DIGESTIVE SYSTEM

81

mouth and ends at the anus. It consists of the mouth,
the esophagus or gullet, the stomach, the small and large
intestines. Two large glands, the liver and pancreas,

Nu.se

Large Intes-
tine

Salivary
(parotid) gland

Vermiform appendix

Rectum

Fig. 4. — General scheme of the digestive tract, with the chief glands
opening into it (Stockton).

pour their secretions into the small intestine to aid in the
digestion of foods. The alimentary canal, liver, and pan-
creas together constitute the digestive system.
6

82 PERSONAL HYGIENE FOR WOMEN

The contraction of the muscular walls of the digestive
tract is the propelling power that carries the food down-
ward and brings it into contact with the digestive fluids.
These movements will be referred to later, under the
Mechanics of Digestion.

The digestive tract is lined throughout its entire course
by mucous membrane; that lining the mouth gives some
idea of its character. It is from the mucous membrane
lining the stomach and intestines, as well as from the liver
and pancreas, that the digestive fluids are poured forth
into its cavity.

In passing downward the food meets with five different
digestive fluids: the saliva in the mouth; the gastric juice
in the stomach; and the bile, pancreatic, and intestinal
juices in the small intestine. Each digestive fluid acts
only on some particular kinds of food. This action of the
digestive fluids on food is called the chemical part of
digestion.

The Care of the Mouth and Teeth.— It is of the first
importance that the mouth should be kept clean and as
nearly aseptic as possible, for as the food is rolled about
in the mouth by the process of mastication it is obvious
that it will carry all the germs and mucus with it into the
stomach. A nasal spray containing some solution of an
alkaline or antiseptic nature should form an essential part
of the toilet of the mouth.

The Teeth. — From simply an esthetic point of view well-
kept teeth are beautiful and greatly enhance the charm of
the face. But the proper care of the teeth is also essential
to good digestion and good health.

In perhaps the majority of people the teeth are suffi-
ciently far apart for small particles of food to become
lodged between them. If not promptly removed, the heat
and moisture of the mouth, acting on these small particles,
cause their decomposition and set up acid fermentation in
the mouth ; and it is this acid which causes the decay of the
enamel and finally of the teeth. The decayed tooth gives
still further lodgment to particles of food, and these, left

THE DIGESTIVE SYSTEM 83

to decompose, give rise to the most offensive gases, giving
fetor to the breath, poisons the blood, and so injures the
digestive and nervous systems.

Where possible a tooth-pick and dental floss should be
used immediately after each meal; the waxed dental floss
between the teeth, and the flat end of the tooth-pick to
remove any particles that may have worked in about the
roots of the teeth and gums.

A tooth-brush with good tooth-powder should be used
twice a day. The brush should not be too broad, and is
better if slightly curved. The bristles should not be too
hard. The use of tooth-powder, which must be very fine,
or tooth-paste is needed to produce sufficient friction to
clean the teeth well. Warm water is a better solvent than
cold, and, therefore, it is well to use it for cleansing the
teeth.

While it is generally known that decay if neglected will
destroy a tooth, it is not so well known that many teeth are
lost as the result of the accumulation of tartar at the gum
margin. There is a great tendency to this, especially about
the necks of the lower incisors and upon the teeth that are
not used in chewing. The deposit of tartar encroaches
upon the neck of the tooth and presses upon the gum; the
latter becomes irritated or inflamed, and recedes from the
tooth; malnutrition and loosening of the tooth follows.

With very imperfect or decayed teeth proper mastica-
tion is impossible.

The teeth should be examined by a good dentist twice a
year, so that small cavities shall be discovered at an early
stage, the tartar removed, and the teeth kept in their best
condition. This will prevent the early loss of the teeth.
Lost teeth must be replaced, so that the teeth shall be op-
posite each other, for a very important factor in masti-
cation is that the teeth shall strike properly.

Digestion. — The factors controlling digestion are psychic,
mechanical, and chemical.

Briefly stated, the process of digestion consists first in
the liquefaction of the solid portions of food and the con-

84

PERSONAL HYGIENE FOR WOMEN

version of the insoluble into soluble and diffusible, for no
nutriment can be assimilated until reduced to a state in
which it can pass through a cell membrane. These
chemical changes are carried on by a series of enzymes.

Fig. 5.— -Location of the viscera of the body and their relation
to each other: D, D, Lungs with air expelled; E, E, diaphragm
cut away to show, F, liver cut to show stomach; 2, gall-bladder;
H, H, large intestine; K, small intestine; L, vermiform appendix
(after Heath).

Enzymes are unorganized ferments which possess the
power of producing chemical changes in certain substances
with which they come in contact under particular condi-

THE DIGESTIVE SYSTEM 85

tions without themselves suffering permanent alteration.
The digestion of food is largely accomplished by the
specific action of these enzyme bodies, of which every di-
gestive fluid contains one or more.

But neither solubility nor diffusibility is adequate.
Freely soluble substances like cane-sugar need to undergo
digestive changes just as definite as those carried out in
the case of fats or coagulated proteins. The changes
which they undergo before absorption serve a more fun-
damental purpose than the mere hastening of their passage
through the lining membrane of the intestine.

In the light of modern chemical knowledge we can lie
somewhat specific in regard to the molecular aspects of the
digestive processes. They are probably always cleavages,
large molecules giving rise to smaller ones. When the
original molecule is of extraordinary size, as with proteins
and starches, these cleavages have a serial character, and a
number of intermediary products must accordingly be
formed; that is to say, the earlier products are in turn
subjected to digestion. Such cleavages are generally, if
not always, hydrolytic; that is, water enters into the reac-
tion and its elements are found combined in the products.

The Psychic Aspect or the Effect of the Emotions on
Digestion. — The relation of the emotions to the activities
of the alimentary canal are of very practical importance,
because recent investigations have shown that not only
are the first stages of the digestive processes normally
started by the pleasurable smell, sight, and taste of food,
but also the pouring out of the gastric juice.

The importance of the initial psychic secretion of the
saliva for further digestion is indicated when we realize
that materials can be tasted only when dissolved in the
mouth, and thereby brought into relation with the taste
organs. The saliva which waters the mouth assures the
dissolving of the dry but soluble food even when it is taken
in large amounts.

The importance of the initial psychic secretion of gastric
juice is made clear by the fact that the continued flow of

86 PERSONAL HYGIENE FOR WOMEN

this juice during digestion not only stimulates the glands
of the stomach to pour out the chemical gastric juice, but
by its action on the mucous membrane of the duodenum
it also starts the flow of bile and pancreatic juice.

These facts are of fundamental importance in the cooking
and serving of food, especially when the appetite is fickle.
A bright and cheery dining-room, the daintiness of the
table service, the center-piece of ferns or flowers, all are
factors in exciting the pleasurable emotions, and so stimu-
late the appetite.

On the other hand, the digestive processes may be wholly
'abolished by vexation, worry, and anxiety, or when such
strong emotions as anger or fear are allowed to prevail.
This fact has long been known in regard to the salivary
secretion, and it has now been established in regard to the
secretion of the gastric juice. It is necessary to avoid all
circumstances likely to provoke emotional reactions.

The inhibitory influence of excitement on the flow of the
gastric juice has been studied by Professor Cannon, of
Harvard University, in an interesting series of experiments
on dogs. And a most important point is that the cat,
which was allowed to infuriate the dog being experimented
on, was only in the room for five minutes, and in spite of
the fact that the animal was hungry and ate eagerly; there
was almost a complete suppression of the flow of gastric
juice for a period of twenty minutes.

A similar experiment was tried on a boy with a gastric
fistula. Food was shown to the boy and then withheld.
He was so vexed because he could not eat at once that he
began to cry and flew into a towering passion, with the
result that no secretion appeared even after the child was
calmed. In both the case of the dog and boy there was
not only a temporary inhibition of the flow of gastric juice,
but it is a noteworthy fact that the effects of the emotional
excitement remained long after its cause had been re-
moved.

The practical point is, that if the digestive processes
have been inhibited by emotional disturbances any food

THE DIGESTIVE SYSTEM 87

taken will lie stagnant in the stomach; and not only will
there be a suppression of the gastric but of the pancreatic
secretion as well, with the consequence that there is likely
to be an accumulation of unabsorbed organic material in
the colon and perhaps higher up as well. Bacterial decom-
position will be fostered and actual harm may be done the
organism.

And just as a single occasion may lead to a passing diges-
tive disturbance, so continual mental depression, worry, or
grief may permanently impair the working of the tract and
so undermine the vigor and capacity of the sufferer.

It is believed that many acute attacks of indigestion in
children are due to sharp rebukes administered at the
table.

The Psychic Tone. — Just as there is a psychic secretion,
so likewise there is a "psychic tone," or psychic contraction
of the gastro-intestinal muscles, as a result of taking food.
And just as the secretory activities of the stomach are in-
hibited by strong emotions, so also are the movements of
the stomach. And, indeed, the movements of nearly the
entire alimentary canal are almost completely stopped
during moments of great excitement.

The condition of mental discord may thus give rise to a
sense of gastric inertia, so that anxiety may be accom-
panied by a feeling of weight as if the food remained in the
stomach, and every addition of food causes an increase of
the distress.

The Importance of the Mechanical Factor in Digestion.
—The mechanical reduction of food in the alimentary
canal is preliminary to its actual digestion. The first stage
of digestion takes place in the mouth, and this is the only
portion of the digestive canal which is under the control of
the will. It is here that the food is ground into fine par-
ticles by the act of mastication, and the more thoroughly
the food is pulverized in the mouth, the more rapidly and
easily can it be acted on by the gastric juice, and the
very act of chewing increases the flow of saliva as well as,
shortens the time that the food will remain in the stomach.

88

PERSONAL HYGIENE FOR WOMEN

The saliva not only protects the mucous membrane of the
mouth, but it keeps it free from small food particles, which
if allowed to remain would decompose, and thus injure
the teeth by the action upon them by the acids produced.

Fig. 6.— The ribs removed, showing relation of thoracic to ab-
dominal viscera: A, Trachea; B, heart; C, C, lungs: D. liver; E,
stomach; F, small intestine; G, large intestine; H, bladder (after
Masse).

It also moistens the dry food, aids in the process of swal-
lowing, and has some action on the starchy substances of
the food. By the process of mastication, then, the food
is divided into small particles and thoroughly .admixed

THE DIGESTIVE SYSTEM 89

with the saliva until the whole is converted into a fine
pulp.

Besides favoring the mechanical part of digestion and its
slight chemical action on starchy foods, saliva, being an
alkaline fluid, is a distinct stimulation to the secretion of
gastric juice. After the food has been reduced into a pulp
in the mouth, and the change of starches into sugar has
begun, it is swallowed and passes into the next compart-
ment of the digestive apparatus, namely, the stomach.

The stomach may be felt at the lower extremity of the
breast bone, in the triangular space formed by the diverg-
ence of the ribs. It is a large hollow, compound gland, the
walls of which contain muscular fibers in addition to the
tubules which elaborate the special secretions. Its cavity
is lined with a thick mucous membrane, packed with
tubular glands, into which is poured out a complex secre-
tion called the gastric juice.

The Chemical Changes which Food Undergoes in the
Stomach. — There are two chief phases or periods of gastric
secretion: (a) The psychic or appetite juice, and (6) the
chemical juice. Gastric juice is not constantly poured into
the stomach to accumulate there, but is secreted only as it
is needed under the influence of certain stimuli. These
stimuli may be classified as psychic and chemical.

In the second phase, or period of gastric digestion, the
exciting agent is the presence of food in the stomach. It
has been shown that a correlation of the different organs of
the body is brought about by hormones or chemical mes-
sengers. The hormones of gastric digestion are produced
from proteins in the early stage of gastric digestion, and
this shows the importance of the psychic or appetite juice.
A similar effect is produced by meat extracts or infusions,
which are well-known provocatives of gastric secretion.

Gastric Juice. — The principal active agents of the gastric
juice are hydrochloric acid and the enzymes; pepsin, the
proteolytic enzyme; rennin, the milk-curdling ferment;
and lipase, the fat-splitting ferment. The uses of the gas-
tric juice are digestive, activating, and disinfecting.

90 PERSONAL HYGIENE FOR WOMEN

Gastric juice does not dissolve and chemically change
all food that enters the stomach, but acts only on that
class of foods called proteins, converting them into pep-
tones.

The changes which food undergoes in the stomach are as
follows: food is disintegrated; meat is broken up, gelatin
dissolved; the muscle-fibers fall apart, and are split into
disks and sarcous elements; the framework of fatty tissue
undergoes similar dissolution of cellular membranes; milk
is curdled; the caseinogen is transformed into casein, and
the latter broken down by pepsin. Bread and other
starchy foods are disintegrated, some of the starch being
formed into sugar by ptyalin. The other vegetable foods
are but little digested by this viscus. The whole is broken
into irregular fragments by the disintegrating power of
the stomach and gradually converted into chyme, the
creamy emulsion which passes through the pylorus into
the intestines. The passage from the stomach into the
duodenum is aided by the motor activity of this organ.

The Mechanics of Digestion in the Stomach. — Recent in-
vestigations, especially those of Cannon, have thrown
much light on this subject. The food introduced into the
stomach from the esophagus is lodged first in the f undus or
cardiac end of the stomach ; from here it is moved by slow
degrees toward the pylorus, from which it enters the small
intestine. Formerly it was taught that this movement
was brought about by a churning motion of the stomach
throughout its entire length. Cannon has shown the error
of this conclusion. From his observations it appears that
the stomach is quiet at first. The waves of peristaltic conr
striction begin at the duodenal and middle portions and
move the food toward the pylorus. In this way the con-
strictions that begin near the pyloric end gradually extend
to the cardiac end. The latter part of the stomach is dis-
tended after a full meal, but gradually diminishes in size
during digestion.

Moreover, there is a difference in the character of the
gastric juice coming from the different areas of the stom-

THE DIGESTIVE SYSTEM 91

ach; that from the middle portion being acid, and that
from the cardiac and pyloric being neutral or nearly so.
These facts show that the food remains for some time in the
f undus and meets there a neutral liquid ; consequently, the
alkalinity of the mass is retained for a time, and the saliva
acts upon the starch for a much longer period than has
been supposed.

It is believed that the length of time which food remains
in the stomach varies with its kind. The digesting mass is
not forced into the intestine until it becomes well saturated
with the free acid of the stomach, a result that will be
reached later with a meat than with a vegetable diet; for
it is plain that much more acid will be required to com-
bine with the proteins of meat than with the smaller
amounts in the carbohydrate foods, and so free acid is
longer in accumulating.

Digestion is aided by the movements of the food mass
through the contractions of the walls of the stomach, so
that anything which lowers the tone of the stomach or
impairs the integrity of its lining membrane seriously
interferes with the digestive processes.

The nature of the food influences the rate of its passage
through the pylorus. It has been shown by means of the
x-rays that when the meal consisted of lean meat, suet, and
rice, properly cooked and prepared in such a manner that
the constituents were properly mixed together, the carbo-
hydrates (rice) began to leave the stomach in fifteen min-
utes, but the protein (lean meat) and fat did not begin to
leave it under one-half hour, and were much longer in
passing through.

It was further found that in a normal stomach a meal of
rice and potatoes gete out of the stomach rapidly, no trace
being left in three hours, while a meal of protein and fat
meat was much slower, some being present six hours after
the meal. Indigestible substances are rejected by the
sphincter and returned to the digestive cavity over and
ovrr again, but in the course of time the sphincter relaxes
and the peristaltic contractions increase, until the force is

92 PERSONAL HYGIENE FOR WOMEN

sufficient to drive through the opening hard substances like
peas, plum-stones, and coins.

The Absorption of Food from the Stomach. — A very wide-
spread misconception prevails in regard to the amount of
absorption that takes place through the gastric walls.
This is very limited indeed; some sugar, alcohol and other
fluids, and a small proportion of nitrogenous matter are
taken up, but that is all. The legitimate r61e of the
stomach is a peptonizer and grinder only. Absorption of
nutrients is the special work of the intestines, and occu-
pies but a subordinate place in the duties of the stomach.

Proteins undergo peptonization, but that does not
change them sufficiently. The mere splitting into pep-
tones, formerly thought sufficient, is now known to be quite
inadequate. Recent researches have shown that the com-
plex protein molecule has to be quite crushed into a hetero-
geneous assemblage of fragments, from which those suitable
for building up into the body protein are selected for that
purpose, the remainder being used as fuel; that is, as a
source of energy. In the case of the other food principles,
fats and starches, the chemical processes are much simpler.

Intestinal Digestion. — The chemical changes which
food undergoes in the small and large intestines are ex-
ceedingly complex. Digestion in the intestine is due to
the combined action of the bile, pancreatic juice, and suc-
cus entericus. The material which enters the duodenum
from the stomach is known as the chyme. The acid chyme
provokes a flow of bile and pancreatic juice. It acts upon
the prosecretin in the duodenal mucous membrane in such a
manner that secretin, a hormone, is formed and carried by
the blood to the cells of the pancreas which it stimulates.

Bile is a secretion of the cells of the liver and from the
inner wall of the gall-bladder; after elaboration, bile is
stored up in part at least in the gall-bladder. The secre-
tion of bile is irregular in quantity, as is the case with the
gastric juice, and appears to be induced by chemical ex-
citants, of which acids, especially hydrochloric, seems to be
especially effective. Of the nutrients, the proteins exert

THE DIGESTIVE SYSTEM 93

the most influence. Less secretion follows the ingestion
of carbohydrates than of proteins.

Formerly it was supposed that fatty foods checked the
secretion of bile, but later experiments have proved that,
to the contrary, they increase its secretion; and olive oil is
a powerful cholagogue.

Bile precipitates the proteins of the chyme, neutralizes
the acidity of the gastic juice, dissolving the fatty acids,
and activates the lipase or steapsin of the pancreatic juice
and assists in the absorption of fats. When for any reason
the discharge of bile is retarded and the organism attempts
to eliminate it through the kidneys, the tissues become
charged with its compounds and take on a yellowish color-
ation.

Pancreatic Juice. — The second action upon the food in
the intestine is that of the bicarbonate of soda contained
in the pancreatic and intestinal juices, which neutralizes
its acidity; and pancreatic digestion can only take place in
an alkaline medium.

The pancreatic juice has the most comprehensive action
of all of the digestive fluids; it contains a great variety of
enzymes and acts upon all classes of nutrients. Its flow
is intermittent, being induced by the action of the acids in
the partially digested food from the stomach.

The pancreatic secretion attains its maximum pressure
about three hours after a meal, but this varies according
to the character of the meal. The enzymes of the pan-
creatic fluid are trypsin, amylopsin, lipase or steapsin, and
pancreatic rennin.

Trypsin. — Pancreatic juice alone has but little influ-
ence on proteins, but when mixed with succus entericus its
influence is great. Trypsin differs from pepsin by acting
in an alkaline or neutral solution, and a free mineral acid,
like hydrochloric, stops its operations; it acts much more
powerfully and rapidly than pepsin. In conjunction with
other enzymes it splits protein foods into simpler com-
pounds, which may be regarded as the building stones of
the original proteins.

94 PERSONAL HYGIENE FOR WOMEN

Amylopsin. — The digestion of starch in the intestine is
mainly effected by means of a diastatic ferment or enzyme
in the pancreatic juice, called "amylopsin." This enzyme
has the power of hydrolyzing the starch mostly into
maltose.

Steapsin or Lipase. — The pancreatic secretion acts vigor-
ously on fats, not only splitting them into fatty acids and
glycerin, but, in conjunction with the bile, also effects
their emulsification. This latter result is doubtless aided
by the soaps which form a union of the fatty acids and al-
kaline bases (mostly sodium) in the bile. The cleavage of
the fats is due to the enzyme steapsin.

The sweats entericus is the secretion of the glands of
Lieberkuhn. It contains quite a number of enzymes, in-
cluding four which act on carbohydrates, namely, amylase,
maUase, lactase, and invertase; the proteolytic enzyme is
erepsin, which seems to supplement the action of trypsin.
It has no action on native proteins except casein, but it
breaks down proteoses and peptones into amino-acids.

In other words, the discovery of erepsin in the succus
entericus and its effects has led to the now almost gener-
ally accepted view that the digestion of the proteins is
carried further than the stage of proteoses and peptones;
in fact, that this enzyme hydrolyzes them into amino-
acids, in which form they are taken up by the cells of the
intestinal mucous membrane.

The Absorption of Food from the Intestines. — It was for-
merly believed that the main stream of the nutrient
passed out of the intestines through the lacteals and
thoracic duct into the circulation. But it is now known
that only the fats take this course, and that the dissolved
proteins, carbohydrates, some fats and salts find their way
into the circulation through the portal system and the liver.

The blood contains a constant proportion of serum-albu-
min and serum-globulin, which are constructed out of the
amino-acids resulting from the digestion of protein foods.
The reconstruction of proteins 4&kes place chiefly in the
cells. Fuchs believes that the amino-acids from the food

THE DIGESTIVE SYSTEM 95

are carried to all the tissues; and that the cells of the
muscles and glands pick out from the blood the "building
stones" necessary for the construction of their special
proteins.

Fat is absorbed for the most part in the form of an emul-
sion and as a solution of soap. Only about 60 per cent, of
the fat in the food is absorbed by the lacteals; the remain-
ing 40 per cent, gets directly into the blood. The fat is
carried directly by the blood-stream to the tissues all over
the body; it is oxidized in the tissues to produce heat and
energy; what is not immediately used for this purpose is
stored up in the cells for future use.

Carbohydrates. — Practically all of the carbohydrates
digested are absorbed in the form of sugar. The absorp-
tion takes place more rapidly in the upper than in the
lower bowel. A portion of the ingested carbohydrates is
destroyed in the alimentary canal by bacteria, whose en-
zymes transform them into various acids and gases.

The Absorption of Sugar. — The sugars pass into the blood
through the portal circulation, and not through the lymph-
atic vessels. The question is, Where does sugar go after it
gets into the blood? The proportion of sugar in the general
circulation is not greater after a meal than before it. It is
necessary that there should be some means of storing it, for
it cannot all be immediately used for the production of
energy. Is it stored as glycogen? Bunge believes that a
considerable amount of carbohydrate is stored as fat, since
the total amount of glycogen in the liver never exceeds
150 grams, and there is a similar store in the whole mass
of muscles. It is evident, therefore, that only a small
proportion of carbohydrates is laid down as glycogen, and
we must assume that the greater part of it is converted
into fat. That fat accumulates in the body on a purely
carbohydrate diet is proved beyond a doubt, and the for-
mation of fat from sugar is considered proved by exper-
imental evidence.

Sugar is an important source of energy for the muscles,
and provision is made for a sufficiency of it always to be in

96 PERSONAL HYGIENE FOR WOMEN

the blood circulating through them, and the storehouse
from which it is derived is the liver. When the liver and
muscles contain enough glycogen to keep the blood supplied
with it, the excess of sugar is converted into fat, and is re-
converted into sugar when there is a demand for it.

Mechanics of Digestion in the Intestines. — The intestinal
movements, like those of the stomach, have recently been
studied by means of the arrays. There are three kinds:
A pendulum-like motion, consisting of a gentle, sway-
ing, rhythmic movement occurring in all parts of the
intestines. These movements do not affect the whole of
the gut at one time, but occur in successive segments of it,
and are more obvious in those parts which are distended
with food, at a period of three or four hours after a meal.
They are most energetic in the upper and least so in the
lower part of the gut, and proceed from above downward
with the course of the food.

The movement consists in lengthening and narrowing,
followed by shortening and widening, of the canal; the con-
traction involves both the longitudinal and circular mus-
cular coats, and in the course of its progress divides the
bowel into many segments. This movement breaks up
the food, sways it backward and forward, diffuses the
digestive fluids through it, and drives chyle into the
lacteals.

The second kind of movement consists of peristalsis, or
wave-like propulsive movements; also localized dilatation,
followed by contraction of the canal, progressing from
above downward at the rate of 1 or 2 inches per second,
and is from three to four hours traveling the entire length
of the intestines.

Under pathologic conditions a third movement is ob-
served, consisting of a swift venicular movement, starting
at the pylorus and traveling the entire length of the gut
in about one minute. It is produced by toxins, gases, and
other irritants.

Digestion is practically completed in the small intestine.

The colon consists of a proximal portion, consisting of the

THE DIGESTIVE SYSTEM 97

cecum, ascending colon, and one-half of the transverse
colon; a mesial part, formed by the other half of the trans-
verse colon and part of the descending colon and a distal
portion, formed by the remainder of the descending colon
and of the rectum. The contents of the proximal portion
are fluid; food accumulates in this portion; it is gradually
concentrated by the absorption of water. It has been
shown by the x-rays that a meal reaches the cecum in four
or five hours; the hepatic flexure in six or seven hours; the
splenic flexure in nine hours; and the rectum in about
eighteen hours.

The feces consist of the residue of the food, digestive
secretions, etc. The contents of the alimentary canal be-
come altered in character as they descend its course. The
mass attains a greater density as it descends, more and
more nutrient being absorbed from it, and even in the
colon it becomes more solid; its color is brownish and its
odor characteristic. The amount of feces from an aver-
age mixed diet represents from one-seventh to one-eighth
of the food consumed.

Defecation. — The waste matter which collects in the
lower bowel must be evacuated every day. Allowed to
remain longer than this, the digestive system is clogged by
the non-removal of worn-out material, and the blood is
constantly absorbing matter which is poisonous to the
body. Decomposition goes on without being suspected
by the sufferer.

Intestinal bacteria or organized ferments are present
throughout the entire intestinal canal and play a part in
the food changes. They are most abundant in the lower
part of the small intestine and the upper part of the large.
They act upon the proteins, causing putrefaction, dissolve
cellulose, and cause a decomposition of the carbohydrates.
The products of these fermentations include indol and
skatol, which have the characteristic fecal odor; volatile
fatty acids and gases, some of which are carbon dioxid,
hydrogen, marsh-gas, and hydrogen sulphid.

Fermentations of this character up to a certain extent
7

98 PERSONAL HYGIENE FOR WOMEN

are normal and may be beneficial, but they may proceed
so far as to be deleterious to health. Anything which
retards digestion, such as imperfect mastication, excessive
eating, abnormal amounts of meat in the diet, and failure
of the organs secreting the digestive fluids to supply these
secretions in sufficient quantity, gives these bacteria a
better opportunity to act on the food residues and so in-
creases their bad effects.

Some foods, especially vegetables of the leguminous
class, appear to be provocative of excessive intestinal fer-
mentation. Flatulence and even toxic poisoning may be
the result of great bacterial activity in the digestive tract.
It is hardly possible to check this by administering septics,
but purging is of value by removing the fermentative
material. Particular foods, especially soured milk and
kephir, have been shown to have a preventive action on
putrefaction.

Influence of Food on Secretion. — The more recent inves-
tigations reveal the fact that the kind of food has an influ-
ence not only on the abundance, but also on the kind of
digestive secretions; this is most important because an
abundant supply of digestive juices is necessary for good
digestion. Broths, meat extracts, and milk stimulate the
secretion of the gastric juice, which makes rational the
taking of soup or bouillon as the first course at dinner, or
the eating of toast or zwieback by persons with weak di-
gestions. Fats, on the other hand, tend to inhibit gastric
secretion, so that an excessive .proportion of fat in the meat
might hinder digestion in the stomach.

Food may exert an indirect influence on the pancreatic
secretion. The acid in the chyme stimulates the flow of
pancreatic juice. One is almost inclined to speak of the
physiologic education of the digestive glands, and to con-
ceive them as being trained for fat, protein, or carbohy-
drate digestion.

Metabolism. — Life consists, so far as material phenom-
ena are concerned, in the transformation of matter into
energy. To these transformations the term metabolism is

THE DIGESTIVE SYSTEM 99

applied. In the metabolism of matter the changes are
chemical; in energy the changes are physical. It is com-
monly assumed that the laws of conservation of matter and
energy are conformed to or obeyed in animal bodies.

The body converts potential into kinetic energy by
metabolism in the body. The potential energy of food is
transformed into the actual energy of heat and mechanical
labor. In this respect the only difference beteen man and
other vertebrates is the nervous and intellectual processes,
which are not yet understood.

Metabolism is anabolic and katabolic. Anabolism is
constructive; it includes growth and the act of the tissues
in selecting, appropriating, and making substances ab-
sorbed from the alimentary canal a part of themselves.
The body is never stable ; while growth and nutrition pro-
gress, destruction or demolition takes place, and this is
called katabolism. To ascertain the exact amount of
matter and energy used daily by the body a balance sheet
of the exchange of material is necessary. The income
consists of (a) matter — food, drink, and the oxygen of the
air; (6) energy, the potential energy of the food and drink.
The outgo consists of (a) matter in the feces, urine, perspira-
tion, and breath; (6) energy — the potential energy of feces,
urine, products of respiration, and perspiration. A com-
plete account would show the amount of C, N, H, O, P, S,
Cl, Na, Ca, K, Mg, and Fe in the income and outgo, it
would also show the compounds in the excreta, including
proteins, carbohydrates, water, and carbonic acid.

Experiments show that the body requires a given quan-
tity of given energy producing substances for sustenance,
and something more to meet the demands for muscular
work.

The metabolism of nitrogen is usually measured by the
amount of urea in the urine, taking into account the
small proportion of uric acid and other nitrogenous bodies.
In fasting the organism lives on its own flesh and fat.

The Effects of a Nitrogenous Diet on Metabolism. — The
most striking effect of a purely nitrogenous diet is a large

100 PERSONAL HYGIENE FOR WOMEN

increase in the nitrogenous metabolism, but it also in-
creases the metabolism of the non-nitrogenous elements of
the body. With an ordinary mixed diet the normal ex-
cretion of urea varies from 33 to 37 grams a day, while
with a meat diet the urea may rise to 50 or even 80 grams
daily.

Carbohydrates as a Protein Protector. — It has long been
observed that when there was a deficiency of protein in the
food the metabolism of nitrogen will be spared and the
tissues protected if the food contains plenty of carbohy-
drates and fat. The subject was fully investigated by
Lusk. When the diet contains an abundance of protein,
carbohydrates, and fat the organism gains a little nitrogen;
when the diet contains the same amount of protein but
no carbohydrates, the body loses considerable nitrogen.
Again, when the food was the ordinary mixed kind, and
contained a sufficiency of energy, but was of a low protein
character, the excretion of nitrogen was normal. These
results led to the conclusion that the carbohydrates were
a protein protector.

Fat as a Protector of Proteins. — The metabolism of nitrog-
enous tissue and elimination of nitrogen is not prevented
by the consumption of fat, but the consumption of fat
reduces the metabolism of protein so much that one-quarter
or one-third as much meat will suffice to maintain the
nitrogen equilibrium as would have to be consumed if only
lean meat was used.

The nutritive value of meat extracts is comparatively
small; their chief value is in promoting digestion and
metabolism of other foods.

Water and Metabolism. — The body consists of 530 parts
of water per 1000. It is of greatest importance as a com-
ponent of the tissues to assist in the exchange of nutritive
substances, the discharge of the products of metabolism,
the regulation of temperature, and other vital functions.
If the supply of water is stopped the body will die, and it
may die sooner from the deprivation of water than from
starvation. •

THE DIGESTIVE SYSTEM 101

A reduction in the amount of water consumed acceler-
ates the decomposition of protein and fat to replace the
water essential for the bodily functions. As the result
of experiments it has been found that the average income
of water is 4 pints, and the excretion is 4$ pints; so that
at the lowest estimate \ pint of water is formed in the tis-
sues by the oxidation of hydrogen in the food and tissues;
and during ordinary work it was found that 17 ounces of
water was excreted daily in excess of that consumed in
food and drink.

The intense suffering entailed by prolonged thirst is to
be accounted for by the absolute necessity for preserving
the normal aqueous dilution throughout the body.

Water is also essential for removing the effete materials
arising from metabolism, cell growth, and other disintegra-
tion.

Chlorids. — About 15 to 18 grams of sodium chlorid
(common salt) are excreted daily in the urine, and smaller
quantities In the feces and perspiration. It is, therefore,
a most important food. The tissues retain common salt
most tenaciously, and when there is none in the food it
gradually disappears from the urine. It facilitates the
absorption of the protein foods and increases tissue metabo-
lism. And, further, an insufficiency of common salt is
followed by a diminution of hydrochloric acid from the
gastric juice, and consequently a failure of nutrition.
There can be no doubt that the hydrochloric acid of the
gastric juice originates from the chlorids of the blood.

On the other hand, a very large number of people con-
sume more salt than they require. Salt is not only a food,
it is a condiment, and as such it is liable to abuse. It has
been estimated that from 2 to 4 grams of salt a day is
sufficient, whereas most people take from 20 to 30 grams
daily in one way or another. The kidneys have to excrete
the excess of salt, which they seem to do in health without
any difficulty; but in nephritis the kidneys do not excrete
R so readily, and this may lead to a retention of salt in the
body.

102 PERSONAL HYGIENE FOR WOMEN

Iron is essential to the human body. It is taken into
the body in the form of food, and is excreted from the
body in the bile and feces. It has been estimated that
typical food contains 10 mgm. of iron daily. The hemo-
globin of the blood contains 0.04 per cent, of iron.

Constipation. — It must be remembered that the intes-
tine is a permanent source of poisons, which, under certain
conditions, cause grave alterations in the principal organs,
notably in the liver, kidneys, and skin, and serious func-
tional disturbances of the nervous system.

Normally, the organism manages to protect itself against
the microorganisms which are found in the intestines;
given, however, certain conditions, the toxic products
can be generated in excess of the powers of the organism
to dispose of them, such as errors of diet, quantitative
or qualitative, atony of the muscular walls of the intestine,
and, above all, constipation. The higher up in the in-
testine the stasis occurs, the more serious is the result.
Constipation is considered by many surgeons as the most
important factor in the production of appendicitis.

There is frequently a condition present which is known
as semiconstipation, and which is most deceptive to the
patient. There may be a bowel movement every day,
but the bowel is never emptied; only the lower portion of
the hardened fecal matter is broken off. This is repeat-
edly found to be the case in examining women for some
form of pelvic trouble, and in a woman who says that she
has a daily evacuation of the bowels, and has had one that
very morning, the sigmoid flexure will be found to be
packed with hardened feces.

Besides the clogging up of the digestive system by the
non-removal of the waste-products of digestion, the
formation of hemorrhoids, which is caused by the mechan-
ical pressure on the veins, and so interferes with their
emptying out in the normal way, and the general auto-
intoxication of the entire system, there are also caused in
women serious displacements of the pelvic organs to-
gether with their congestion and inflammation.

THE DIGESTIVE SYSTEM 103

The general symptoms of autointoxication are: head-
ache, vertigo, palpitation of the heart, a feeble and irreg-
ular pulse, irritability of temper, melancholia, numbness
and tingling in the hands and feet, and the emaciation and
loss of weight are sometimes so marked as to lead to the
suspicion of malignant disease.

Treatment of Constipation. — This should always be
preventive, and the diet is a most important factor. The
food should be of a coarse quality, that is, such as directly
stimulates the walls of the intestine to contraction by their
constitutents, or by the large amount of the indigestible
bulk. Corn and Graham bread should be substituted for
white bread. Toast is always constipating. Plenty of
fresh fruit and vegetables should be eaten. For those who
can digest them, raw apples, eaten just before retiring, are
a great aid. The drinking of a sufficient quantity of water
daily is also essential, and this quantity must be 3 pints.
A glassful of cold water, taken the first thing in the morn-
ing on rising, is often very effective. If this is insufficient,
the phosphate of soda, one teaspoonful to one tablespoon-
ful, may be added.

Habit. — Nowhere is the effect of habit more conspicuous
than in the matter of a daily evacuation of the bowels.
There should be a fixed time every day for this, and the
very best time is in the morning, directly after breakfast.
Such a habit, once established, will enforce itself upon the
attention and make regularity a necessity. It not infre-
quently happens that constipation is the result of irregu-
larity in going to the toilet. The school-girl or woman
gets up a little late, and, although she may feel the inclina-
tion to empty the bowels, she is able to defer it.

If the movement is sufficiently large, one stool daily is
sufficient, but where the stool is slight in quantity, there
may be two or three during the day, entirely consistent
with health, and in a run down state of the system there
are apt to be several small movements rather than one full
stool. So long as the stools are not watery, the individual
may rest assured that there is no looseness of the bowels.

104 PERSONAL HYGIENE FOR WOMEN

Constipation should never be allowed to become chronic.
It is, as has already been shown, the progenitor of myriads
of the most serious diseases; and, after the bad habits
of years have been established, it is one of the most
obstinate of diseases to cure. In every case a good
physician should be consulted at once, and the treatment
should be persevered in until the cure is complete. It is a
well-known fact that all medicines for this trouble lose
their effect, the dose has to be increased, and a frequent
change made from one laxative to another. When every-
thing else fails, electricity may be resorted to. It is one
of our most valuable remedies, since it brings about a cure
through the toning up of the muscular walls of the in-
testine.

The constant use of hot clysters to empty the rectum
is one of the most pernicious habits; in this manner the
bowel becomes overdistended and loses its tone, and the
fecal mass is not sufficiently large to cause the distention
of the rectum, which is the normal stimulus leading to the
desire to defecate.

The Amount of Food Required. — Food is required for
growth and for repair; that is, to build up the organism and
make good the loses sustained by physiologic processes, to
maintain the heat of the organism, and to supply it with
mechanical energy.

It has become an established custom to compare the
human body to a machine. Both derive their power from
fuel; in both instances the potential energy of the fuel is
transformed into kinetic energy or mechanical power
which works the machine; in both cases the energy which
is not used in work escapes in the form of heat.

The human body uses the mechanical power chiefly in
muscular work; the heat is used in warming the body and
causing the evaporation of moisture from its surface. The
animal organism is much superior to the mechanical engine.
It is more economic in the use of fuel; it has a nervous
organization rendering it sensible to impressions and cap-
able of directing its energies. The human machine is

THE DIGESTIVE SYSTEM 105

capable of adapting itself to many circumstances and
changes in the demands upon it.

But to enable the body to continue to perform these func-
tions indefinitely it must be properly fed, and a proper feed-
ing of the body requires a knowledge of its composition and
the exchanges which are constantly going on. This knowl-
edge is to be derived from a study of its metabolism, the
analysis of foods, and a determination of their heat values.

The Classification of Foods. — Foods are divided into
proteins, carbohydrates, fats, mineral salts, and water.
The body is composed of materials belonging to the same
groups. Proteins form the principal part of muscles, bones,
and many other tissues of animal bodies; they also consti-
tute some of the most important vegetable structures.

Proteins are probably the most complex compounds in
nature; all contain carbon, hydrogen, oxygen, and nitrogen,
generally sulphur, and sometimes phosphorus also. They
are, with rare exceptions, colloids, that is, glue-like, non-
crystalline bodies, which even in solution cannot pass
through animal membranes.

The building stones of the body are the amino-acids.
All proteins contain them, but the kinds and proportions
are not always the same. It has been shown by biologic
experiments that life and growth cannot be maintained
when certain amino-acids are deficient.

Proteins are of use to the human body as tissue formers,
and, secondly, as producers of energy, but they also have a
food value as flavoring agents, rendering the food appetiz-
ing, and so are to a certain extent stimulants. The palat-
ability of meats and soups are due to their presence. The
amino-acids have decided heat value.

The necessity for proteins in the diet has been abun-
dantly demonstrated. Many investigations have shown
that when the food contains no protein the waste of nitro-
gen continues, no matter how abundant the supply of car-
bohydrates and fats. In other words, a continuous pro-
tein cleavage is demanded by the animal organism, and
no other nutriments can serve as a substitute for protein to

106 PERSONAL HYGIENE FOR WOMEN

meet this demand. If the food contains no protein, the
body tissues will be depleted. It cannot be said that car-
bohydrates or fats are an essential part of the diet in the
sense that protein is, because it is possible to substitute one
for the other to produce energy, or to substitute proteins for
both.

In spite of these facts, it is safe to assert that the wel-
fare of the human organism is best promoted by a mixed
diet, including all three classes of food. The larger part of
man's food is used for the production of energy, and it is
physiologically economic that this energy be supplied by
the non-nitrogenous nutrients, particularly the carbohy-
drates, and to allocate to protein, so far as practicable, its
special role of building material.

Nitrogenous Waste Products. — The end-product of
proteins is urea, which is formed from protein decompo-
sition products in relatively large amounts in the liver
cells, and, being readily soluble and diffusible, is easily
eliminated by the kidneys. Besides urea there are other
smaller quantities of nitrogen compounds, the one most
deserving of notice being uric acid.

When the proteins are broken down to supply energy,
there is always a definite proportion of urea and uric acid
residue that must be eliminated through the kidneys. An
excessive protein diet would burden these organs beyond
their accustomed habit, and flooding the. system with
these nitrogenous wastes increases the tendency to. rheu-
matism and gout.

Uric acid is of general interest, and when present in the
system in abnormally large amounts, as in gouty persons,
has a pathologic significance. It is more complex in its
composition, and, what is of particular importance, is that
it does not readily dissolve. It forms very insoluble salts
which have unpleasant tendencies to settle in the joints,
causing great pain. Did its metabolism proceed properly,
it should be resolved into urea and carbon dioxid. The
quantity of uric acid that appears in the urine is the residue
that has escaped this oxidation.

THE DIGESTIVE SYSTEM 107

Uric acid is built up from purin bodies in the food, so
that it would be well for those with a gouty diathesis to
abstain, at least when an attack of gout threatens, from all
aliment in which purin is at all abundant. The most
valuable of the purin-free foods are eggs and milk, and to
these the uric-acid sufferer has to turn in times of trouble.

Carbohydrates Physiologically Economic. — This group
of compounds comprises starches, sugars, and gums; the
elements of which they are composed — namely, carbon, hy-
drogen, and oxygen — are so balanced that if all of the car-
bon were removed the residual hydrogen and oxygen would
be in the proportions to form water.

Carbohydrates are usually characterized as the fuel por-
tions of the food, or, in other words, that part which is
burned to produce the various forms of energy. They are
also essential for the well-being of the organism; reduction
of the intake below the essential point frequently leads to
acetonuria.

When the metabolism is perfect, any carbohydrates con-
sumed in excess of the ordinary requirements are converted
into glycogen and fat and stored for providing fuel at a
future date. When stored as fats they are completely oxi-
dized in the simplest compounds, carbon dioxid and water,
and are eliminated through the lungs and skin, possibly
part of the water so formed acting as a solvent for the
urinary compounds. Investigations seem to prove that
the body has a preference for the carbohydrates over fats
or other nutrients as a source of energy. There is every
justification for the abundance of starches in man's diet.

Fat is essential in the food of mankind; it is absorbed
ready formed from the food, or manufactured in the body
from the proteins and carbohydrates. Neutral fats and
fatty acids are valuable foods; their primary function is to
supply the body with fuel for heat and energy.

The mineral substances form 5 or 6 per cent, by weight of
the human body, and are constantly leaving it by different
channels; they are indispensable elements of food. They
give solidity and stability to the organism, constituting a

108 PERSONAL HYGIENE FOR WOMEN

considerable proportion of the bones. They keep various
proteins in solution and confer upon them the property of
electric conductivity. They are necessary for all of the
secretions and assist in the general metabolism. The car-
bonates of soda, potash, iron, and other minerals render the
blood and secretions alkaline. The removal of carbon di-
oxid is performed mainly by the alkaline carbonates, which
take it from the blood and surrender it to the lungs. We
have already considered the need of sodium chlorid. The
total daily requirements of salts is estimated at about 360
grains.

Vitamins a New Factor in Nutrition. — But recent in-
vestigation has proved that something more is essential
for the maintenance of growth and well-being than pro-
tein, carbohydrates, fats, and salts; that food contains a
minute portion of accessory bodies, and that when they
are deficient or absent from the diet the immature body
does not grow, the mature body does not maintain its
condition, and there are manifestations of more or less
serious disease. These accessory bodies have been called
"vitamins," and they are essential to maintain the normal
metabolism of the body.

It is recognized that although vitamins are undoubtedly
widely distributed in food products, they occur fdr the
most part in very minute amounts, and the various foods
differ in the proportion which they contain. If the diet is
made up of substances which are poor in vitamins, or ren-
dered so by their mode of preparation, abnormal metabolic
processes have been found to follow.

The study by many scientists during the past few years
of the enzymes and their striking specificity; of the salts;
of the insufficiency of many proteins, and of the vitamins
is epoch making, and has caused a corresponding advance in
dietetics. These discoveries are so important as to raise
the question whether nutritive failure or success does not
depend as much on the accessory bodies — the vitamins,
the enzymes, and lipoids — as on the primary element of
the diet.

THE DIGESTIVE SYSTEM 109

In addition to these food principles, there exists in our
food a number of compounds which, while not indispen-
sable, act beneficially as flavorings, stimulants to diges-
tion, etc.; these are termed food adjuncts, and comprise
such bases as caffein, essential oils, organic acids, etc.

Standard Dietaries: The Maintenance Diet. — There is
great need of standardization and of knowledge regarding
the maintenance diet, first among physicians and then
among the people in general, or scientific dietaries based
on the nutritive value of foods. These are given in terms
of proteins, carbohydrates, and fats, together with the
aggregate energy of the nutritive value in each. This is
the corner-stone of dietetics.

Dietetics is the science of feeding. It has to do with the
necessities of the body and the ability of the food to meet
these necessities in the various circumstances and condi-
tions of life. The ultimate scientific knowledge concerning
human nutrition should be to promote the healthful and
economic use of food.

The problems to be dealt with are quite complex.
These are: (1) changes in the economic conditions of the
population; (2) changes in food production and food sup-
ply; (3) changes in the methods of preparing food.

In regard to the influence of the economic conditions
of the people on the composition of their diet, it might be
expected that a considerable decrease in the earning capac-
ity of the poorer people, or an increase in the cost of foods,
would be followed by a change in their diet. Everyday
experience teaches that under such conditions the more
expensive foods — meat, eggs, and milk — are reduced in the
diet. These same foods are also rich in vitamins, so that a
reduction here would, therefore, reduce the vitamin con-
tent of the dietary unless other dietary complements
rich in vitamins, such as legumes, were introduced.

The value of any food as a source of heat and energy is
measured by a bomb-calorimeter. The heat given off
during the combustion is a measure of the latent or poten-
tial energy of the food. The kinetic energy of the food is

110 PERSONAL HYGIENE FOR WOMEN

the amount of heat developed by the proportion which is
digested. The unit commonly used is the calorie, or the
amount of heat which would be required to raise the tem-
perature of 1 kilogram of water 1° C., which is about
equal to that required to raise the temperature of 1 pound
of water 4° F.

Heat Value and Digestibility of Foods. — One of the chief
functions of food is to supply the body with heat and en-
ergy; the food must be capable of digestion and absorption.
Herein lies the exact value of any food to the consumer.
In science the figures that are given for the digestibility
of the various foods refer to the completeness or extent to
which the food is dissolved and transferred to the circula-
tion, and an indigestible one is that of which a considerable
portion passes out of the system into the feces without be-
ing disintegrated and absorbed.

Animal food is more completely digested than vegetable
food, as shown by the difference of nitrogen in the feces.
In meats 97 per cent, of the protein and 98 per cent, of the
fat are absorbed. Lean meat is more rapidly digested than
fat, and the flesh of young animals than that of older ones.

The breast of chicken, fresh beef, and mutton are among
the most digestible of the solid foods. Raw and rare meats
are more easily digested than well-done meats; in other
words, cooking lessens the digestibility of meats. Steak
should be broiled and never fried ; all fried foods are difficult
to digest. Veal and pork are both difficult to digest.

Eggs are almost as nutritious as meat; their digestibility
is unsurpassed and only equalled by a few foods, such as
milk and oysters. They are most easily digested when
soft boiled or poached. Dry toast finely broken up and
mixed with a soft-boiled egg aids in its digestion. Soft-
boiled eggs are more easily digested than raw eggs, but
the latter are less irritating to the stomach, probably be-
cause they are digested in the intestines. It has been
found that two poached or soft-boiled eggs leave the stom-
ach in from two to three hours; that is, in the same time
as milk, oysters, white bread, and light fish.

THE DIGESTIVE SYSTEM 111

MUk. — Although one of the most completely digested
of foods in a mixed diet, milk is not quite so completely
digested as meat and eggs. When milk is the sole food
(milk diet) the proportion digested depends partly on the
amount consumed. With the consumption of 3^ pints
of milk daily the loss of milk solids varies from 10 to 11.16
per cent. Young children digest milk more completely
than adults.

The addition of aerated waters or crackers broken up in
the milk prevent the formation of tough clots, and hence
render it more digestible. Hot (not boiled) milk is more
digestible than cold. Boiling increases the toughness of
the curd, but it destroys the bacteria. Buttermilk and
koumiss are more easily digested than cows' milk.

Wheat flour enters largely into the diet of every family.
In producing it the outer coating of the wheat kernel is
removed, thus throwing into the milling offals that part of
the kernel which is most heavily charged with mineral
ingredients and vitamins. The proportion of digestible
proteins in white flour is not less than in whole wheat flour,
as is so often claimed, but because the latter is richer in
mineral ingredients its use is recommended.

Bread is readily digestible; white bread digests more
rapidly than brown or black; and crackers more rapidly
than either.

Rice is another cereal of great economic importance.
As a food for invalids it possesses a high value on account
of its digestibility, especially in intestinal diseases. Or-
dinarily polished rice contains only 0.5 per cent, of cellu-
lose, and almost all of the substance of the grain is
absorbed.

There is a perfect analogy between the well-known re-
lation of the polishing of rice to its nutritive value, and the
milling of wheat and com to the nutritive value of wheat,
flour, and cornmeal; that is, it loses the mineral ingredients
and vitamins.

Potatoes. — In European countries potatoes rank next to
bread; this arises from the ease of their digestion. From

112 PERSONAL HYGIENE FOR WOMEN

92 to 95 per cent, of the starch is absorbed, but there is a
loss of 23 per cent, of the protein.

The manner of preparation of vegetable foods determines
the proportion of loss. When potatoes are baked or boiled
in the skins the loss is negligible. The greatest amount of
loss occurs when the skins are removed, the potatoes then
allowed to soak in cold water, and placed in cold water to
boil. The potatoes should be pared just before cooking,
and the water should be boiling hard before they are put in.
Mealy potatoes digest more rapidly than waxy ones, and
mashed quicker than unmashed.

Oatmeal, barley meal, and other cereals which are not
ground very fine do not digest so easily as wheat flour, but
much depends on the mode of cooking. When oatmeal-
gruel is consumed with a sufficient amount of milk it forms
a complete diet.

Nuts are valuable as a source of protein and fat, but they
are rather difficult of digestion.

Fats. — As a rule, children do not thrive whose diet is
deficient in fats, and even adults are prone to tuberculosis
and nervous diseases when fat in the body is deficient.

Cheese is one of the most indigestible of foods. All
fried foods are highly indigestible because the fat envelope
of the foods has to be melted off before the gastric juice
can act on the food substance itself. Pastry is also very
indigestible. Of the vegetables, beans, while highly nu-
tritious, are exceedingly difficult of digestion; also boiled
cabbage, cauliflower, hot breads, iced drinks, ice-cream,
and water-ices.

The Relation of Diet to Various Conditions of Life.—
The chief factors influencing bodily needs are age, height,
weight, occupation, idisoyncrasies, and atmospheric con-
ditions.

All activity of the human body, whether in the main-
tenance of its functions or in the performance of labor, is
work. These two forms of work may be classified as
physiologic and mechanical. Nothing in nutrition is more
important than the relation of food to work.

THE DIGESTIVE SYSTEM 113

Children are practically in constant motion during their
waking hours, and their demand for food energy is from
two to three times as much per unit of weight as that for
adults.

Sex. — Men and women of the same age and weight, doing
the same kind and amount of work, require the same
amount of food. The fact that men usually require more
food than women is because, as a rule, they weigh more, are
more active physically, and perform more external work.

Temperament. — Persons of a nervous type, being more
active, use more energy than the phlegmatic, and, there-
fore, require more food.

Brain Workers. — A man whose work is sedentary and
chiefly mental does not need so much food as a man doing
muscular work. The amount of carbohydrates required
is less, and the amount of fat rather more than for the man
doing light muscular work.

Ranke's diet for the brain worker is: Protein, 100 grams;
fats, 100 grams; carbohydrates, 240 grams; giving an energy
value of 2310 calories.

The diet should not be bulky, but light and easily di-
gestible. Excess of food and heavy foods are especially
bad for brain workers because they produce heaviness,
dulness, and drowsiness. Spiced and rich foods upset the
alimentary functions, whereby the circulation is flooded
with the products of imperfect metabolism to the detri-
ment of the brain.

Trained workmen will do a given amount of labor on less
food than untrained, because when persons take up
mechanical operations with which they are unfamiliar, or
undertake work which exercises a new set of muscles, a
unit of work accomplished costs more in food energy than
when the muscles have been trained to do a particular
thing.

Very strenuous exercise, like athletic contests and unnat-
urally slow movements, are both wasteful of food energy.

Again, a continuance of the same labor for hours, and a
state of fatigue, whether it comes after a longer or shorter
8

114 PERSONAL HYGIENE FOR WOMEN

time, causes an increase in the energy expenditure per unit
of work performed.

Economy in the use of energy that food supplies to the
body is most fully secured when the movements of the
body are at the natural rate; when periods of intense effort
do not occur, and when the labor is not too long continued
and is not carried to the point of fatigue.

Standard for Daily Dietaries (American) — Atwater.

Fuel

Protein, value. Nutritive
Grams. Calories. ratio.

Woman with light muscular exercise 90 2400 5.5

Woman with moderate muscular work . . . . \ , QQ 9700 5 6

Man without muscular work j

Man with light muscular work 112 3000 5.5

Man with moderate muscular work 125 3500 5.8

Man with hard muscular work 150 4500 6.3

The Relation of Food Economics to Social Welfare. —
A virile nation is one whose citizens are of a good physical
type, which means that they are well nourished. A well-
fed people, other conditions being favorable, is a strong
people. Food is the physical basis not only of the indi-
vidual activity, but also of social energy. Any causes,
therefore, which limit the food supply or increase the
burden of securing adequate nourishment strike a blow
at the nation's vital power.

We must constantly keep in mind that the energy output
is practically the energy requirement, under given condi-
tions, of course; and the expenditure caused by the mus-
cular activity of a particular individual cannot be reduced
without affecting the work done or causing the loss of body
substance.

Investigation has shown that there is a necessary daily
protein minimum use. When insufficient protein is taken
in the food, the necessary balance will be supplied by draw-
ing on the tissues of the body. The food standards which
are based on the observation of practice call for not less
than 100 grams of protein daily for professional men and
175 grams for men at severe labor.

THE DIGESTIVE SYSTEM 115

It is held tx> be significant that communities holding
leading positions in the world consume a liberal amount of
protein, or, conversely, that communities with an inferior
physical and mental status use a low proportion of proteins
in the diet. Again, if we argue from the analogies in feed-
ing farm animals, generous protein feeding is desirable for
the growth and maintenance of vigorous organisms and a
satisfactory rate of production.

On the other hand, the well-known experience of the
ages has shown that the poor who live on a low protein diet
ftre the most liable to disease. It cannot be gainsaid that
the meat eater has greater stamina and energy than the
one whose diet is poor in protein.

The conclusion is, that while a minimum of protein is
essential to the organism, a greater proportion is advan-
tageous by acting as a stimulant to the metabolism and as a
ready source of energy; that people are better for the con-
sumption of proteins in quantities greater than in Chit-
tenden's standard, and possess greater resistance to dis-
ease, probably because the body is stimulated to manu-
facture antibodies.

Practical Facts for Guidance. — The housewife who keeps
the following facts in mind may combine foods in an ap-
proximate way that will fully meet the demands of the
human organism.

The proper ratio is 1 part of protein to 5 parts of non-
protein; and the fat should equal one-half of the weight
of the protein. This gives the following normal dietary:

Energy

Weight. supplied.

Grams. Ounces. Calories.

Protein 100 3J 410

Carbohydrates 400 14* 1640

Fate 50 1} 465

2515

Proportion of Proteins in Foods. — Foods Rich in Pro-
teins.— Lean meat, dried peas, beans, and lentils, 18 to 25

116 PERSONAL HYGIENE FOR WOMEN

per cent.; fat meat, 12 to 18 per cent.; eggs, 12 per cent.;
oatmeal, 10 to 15 per cent. ; cheese, 25 to 35 per cent.

Foods with Moderate Amounts of Proteins. — Milk aver-
ages 3^ per cent.; fresh peas, beans, and lentils, 3 to 8 per
cent. ; white bread, 6 to 7 per cent. ; fine wheat flour and
barley, 8 to 10 or 12 per cent.

Food with Usually Less than 3 Per Cent, of Proteins. —
Green vegetables, potatoes, and roots, such as carrots,
turnips, and onions, etc.

Legumes and certain nuts supply relatively more protein
than other vegetable foods, so that when the cost of meat,
fowl, fish, eggs, or milk is prohibitive, the freer use of beans,
peas, lentils, and nuts is strongly recommended.

The unmodified foods, such as grain, vegetables, fruit,
meat, eggs, and milk, may be depended upon to amply
supply all the necessary elements to sustain growth, func-
tions, and waste of the human body. On the other hand,
foods which it is proper to designate as "artificial" are not
only not essential to an adequate diet, but when they are
used freely may render a diet very one-sided or deficient.

Foods may be so selected as to furnish an abundant
supply of mineral ingredients. For instance, the dry sub-
stance of certain vegetables like asparagus, lettuce, spin-
ach, and such animal foods as eggs, and beef extracts are
relatively rich in iron compounds, and the dried substance
of leguminous seeds, carrots and other vegetables, milk,
and cheese are relatively rich in calcium compounds.

Variety of foods is necessary, for monotony of even the
best kinds leads to satiety, loss of appetite, loathing of food,
and subsequent ill-health. Vegetables and fruits are abso-
lutely essential, but raw fruits are not so easily digested
as cooked. Salads, lettuce, water-cress, green onions,
celery, tomatoes, etc., are so valuable for the juices con-
tained in them that they cannot be too strongly recom-
mended to those who can digest them. Similar juices are
contained in cabbage, cauliflower, spinach, etc., but these
are lost to a very great measure in the cooking.

THE DIGESTIVE SYSTEM 117

Oranges, lemons, grapes, strawberries, and bananas con-
tain equally valuable juices, and may be eaten raw with
advantage to the consumer; but apples, pears, plums,
gooseberries, and many other fruits are better cooked
before being eaten.

The simpler the meals, the less work will be expended in
their preparation, and there is no advantage in an elabor-
ate meal. The main thing is that the table should furnish
a sufficient variety from day to day.

The following specimen dietary has been found to be
most satisfactory for women with sedentary occupations.
On it women have maintained good health and other
women have regained their health:

Breakfast. — Fruit, bacon and eggs, breakfast hominy,
rolls or toast and butter, a glass of milk, and one cup of
coffee.

The fruit may be any raw fruit in season except apples
or bananas; apples should always be cooked for breakfast
because they are more easily digested; bananas are too
heavy and indigestible to be served for breakfast. Stewed
prunes are good and especially laxative.

Bacon is not a necessity, though it is an appetizer.
Eggs may be served in any way, though they are most
digestible when soft boiled or poached.

The hominy is boiled in water and served as a vegetable,
with a little salt and butter, but no sugar.

For women with good digestion and taking more active
exercise, oatmeal and cream may be substituted for the
eggs, hominy, and glass of milk.

Luncheon may be served in a very appetizing way from
the cold meat and vegetables which have been left from
the previous day's dinner in the form of stews, baked hash,
etc. Stewed fruit should always be served, and oysters
always make a nice dish for lunch.

The criticism of the ordinary lunch for women is that it
is too light. The food served for lunch should furnish
about 1000 calories; 90 per cent, of these should be in the
form of starches and fats.

118 PERSONAL HYGIENE FOR WOMEN

Dinner, — The following is a balanced ration given in the
Educational Lunch Room of the New York Department of
Health:

Proteins.
Price. Quantity. Calories. Grams.

Vegetable soup 5 cents. £ pint. 150 5

Roast beef 20 cents. 4 oz. lean. 140 30 or

Roast beef with 4 oz. fat. 460 27

Mashed potatoes,

creamed Av. helping. 110 4.0

String beans 5 cents. 2 h. tbsp. 10 .5

Salad a la Saute" 8 cents. Av. helping. 370 2.0

Whole wheat bread 2 slices. 140 5.5

Butter Bounce. 120

Apple pie 5 cents. | pie. 300 4.0

Black coffee 3 cents. 1 cup. .... ....

Sugar 2 squares. 60

46 cents. 1760 or 50 or

1440 53

One glass of water is served with each meal; it should be
taken when the meal is finished.

The mineral waters promote digestion by promoting an
earlier and more abundant secretion of the gastric juice.

Lemon juice should be substituted for vinegar in all
salad dressings. For a French dressing the correct propor-
tions are 1 tablespoonful of lemon juice and water each
to 2 of olive oil. Mix well, and pour over the salad just
before serving.

Three meals a day has been found to be the best ar-
rangement, and there should be an interval of five hours
between the meals. If possible dinner, which is the prin-
cipal meal, should be taken at the end of the day, after its
work is over, so that comparative repose may be enjoyed
after it. It is of extreme importance that the meals be
served at the same hour every day. The perfectly healthy
woman should never take anything to eat between meals.

A hearty meal should never be eaten when one is ex-
hausted or greatly fatigued. Half an hour's rest before
dinner is a great aid to digestion. Sleep directly after a
hearty meal is injurious and sometimes proves fatal be-

THE DIGESTIVE SYSTEM 119

cause there is a depression of the circulation, and the
digestive processes may stop absolutely during sleep.

Preparation of Food. — Fresh meats are highly nutritious,
but in order that the nutritive properties may not be lost
in the cooking, they must be eaten "rare," that is, beef and
mutton should be at least pink.

A roast should be done in a quick oven, so that the al-
bumin shall rapidly coagulate on the surface and prevent
the escape of the nutritive juices. Or if the meat is
boiled, it should for the same reason be plunged into boil-
ing water.

On the other hand, in treating meats in order to ob-
tain "stock" for soup, the meat after having been cut up
into small pieces should be allowed to stand in cold water
for twenty minutes and then be put on to simmer for six
hours or more.

Plenty of bones with gristle should be gotten with the
soup meat; these do not add to the cost, and add mate-
rially to the value of the stock; for, while the gelatinoids
are not flesh formers, they are admirable protein sparers.
The same thing holds true of gelatin and its preparations.

Indigestible Combination of Foods. — The acid of vinegar
being a fermentation acid renders the digestion of many
foods with which it is taken more difficult, while vegetable
acids, such as citric and tartaric, do not cause that objec-
tionable effect. Vinegar also retards salivary and gastric
digestion.

Strong tea taken with any meat meal converts the al-
bumin of the meat into a dense precipitate that is abso-
lutely indigestible. The tannin of tea inhibits the salivary
and gastric secretions and so retards digestion. Indiges-
tion, atony, or catarrh of the stomach is frequently due to
excessive tea drinking, and the artificial stimulation of the
nervous system may be carried so far as to produce in-
somnia, palpitation, muscular tremors, and other signs of
nervous irritability.

Claret and coffee both delay digestion.

120 PERSONAL HYGIENE FOR WOMEN

Water is the best beverage to be taken with meals; but
the moderate use of tea and coffee is commendable be-
cause they have an invigorating effect arising from the
caffein and the essential oils, but their use should not be
abused.

The Proper Way of Making Tea. — The water should be
freshly boiled; the tea-pot heated so that the water will
be maintained at the boiling-point; one teaspoonful of tea
is allowed to the cup. The tea is measured out, put into
the tea-pot, and the requisite amount of boiling water
poured over it. It is then allowed to stand on the kitchen
table, not the range, for from two to three minutes; it
should then be strained into the tea-pot for the table.

Unless the tea is strained off the leaves the infusion
continues for some time; this extracts the tannic acid and
bitter principles. In addition, the prolonged infusion dis-
sipates the volatile oil, to which much of the fragrance of
a good cup of tea is due.

As it is almost impossible to have the requisite amount
of care exercised in the making of tea in the kitchen, it is
much better that it should be made on the table. Sugar
detracts from the healthfulness of the beverage.

Coffee. — Most that has been said about tea is true of
coffee. It is aromatic and refreshing, stimulates the men-
tal activity, invigorates the muscular system, and removes
the sense of fatigue. The excessive use of coffee often leads
to insomnia. Its use retards gastric digestion, but less so
than tea; but strong coffee or cafe* noir has a still greater
inhibitory effect. It has a slightly aperient effect on the
intestines by increasing the peristaltic action. It is also
slightly diuretic.

The aromatic oils are dissipated by boiling, and the best
temperature of the water is 210° F., or just below the boil-
ing-point.

Defective Methods in the Preparation of Breads which
Reduces the Vitamin Contents, Especially of Corn Bread. —
By resorting to artificial methods for procuring the light-

THE DIGESTIVE SYSTEM 121

ness of breads, baking soda (sodium bicarbonate) is used.
In order to prepare bread in this way the cornmeal is
mixed with milk or water to which baking soda has been
added, and put in the oven to bake. The high temperature
of the oven liberates the carbon dioxid (COa) from the
baking soda, causing the bread to rise, and the sodium bi-
carbonate is transformed into sodium carbonate, a strong
alkali. Recent experiments have clearly demonstrated
the destructive action of the alkalies on the vitamins, this
being especially true at high temperatures.

It should be strongly emphasized that the old-fashioned
way of combining baking soda with sour milk in the prepa-
ration of bread is an entirely harmless procedure, provided
that sufficient sour milk is added to perfectly neutralize the
alkalinity of the soda. The label on some brands of baking
soda clearly states that sour milk, or tartaric acid, should
be added in order to obtain the best results.

Dietary in the Tropics. — Sir R. Havelock Charles says,
"It is impossible to form exact rules for dietary in the
tropics because there are differences in climate which re-
quire modifications." He says nothing about limiting the
amount of meat, but he does say, "no cold meat whatever
should come on the table." It is important that every-
thing should come straight from the fire to the table. It
cannot then cause bacillary mischief, and there should be
no fear of cholera or dysentery.

Boiled water only should be drunk. No salads of any
kind should be used except in the greatest moderation.

Fruit. — Every fruit which possesses a rind that can be
removed may be eaten raw with impunity by a healthy
man at any time of the year. Fruits which do not possess
a rind are incapable of being thoroughly cleansed; such
fruit may be contaminated and dangerous' to the consumer,
and, at any rate, ought only to be eaten after it is cooked.
Therefore oranges, grape-fruit, pears, apples, bananas,
mangoes, pineapples, custard-apples, mangosteen, toma-
toes, etc., may be eaten raw after peeling them. But it

122 PERSONAL HYGIENE FOR WOMEN

would be unsafe to eat grapes, currants, strawberries, and
other fruits which cannot be peeled until they are cooked.

As regards proteins, some fish, fowl, or meat may be
taken for breakfast; animal food ought not to be taken in
the middle of the day. It is is better to take dinner in the
evening. Beef, mutton, pork, kid (goat-flesh), venison
(deer and antelope), poultry, many kinds of birds, eggs,
and fish are obtainable in one place or another. Tinned
meats and fish should be avoided; indeed, the importance
of fresh meat is so great that hunting, shooting, and fish-
ing should be strongly recommended as exercise.

Fat is obtained in the form of meat, dripping, butter,
ghee, nuts, and various oils used in cooking. The pure oil
from peanuts, palm-nuts, and cocoanuts is salutary; but
many samples are adulterated with sesame" oil, poppy-seed
oil, and colza oil, which are deleterious by causing dyspep-
sia or other gastro-intestinal troubles. These in turn ren-
der the subject susceptible to dysentery, sprue, and other
tropical disorders.

Food Economics : Regulation of Diet with Reference to
Minimum Expenditure. — The cost of a meal for an indi-
vidual or a family is made up of two factors — the money
cost of the raw materials, and the time, cost of labor, and
other expenses required for the preparation and serving of
the food.

The Cost of Raw Food Materials. — Meats of all kinds,
poultry, and fish are the most expensive articles of diet.
Then, too, the waste has to be considered — the bones and
legs of a dressed fowl and the bones and skin of fish.

At the present time the dairy products supply the cheap-
est nutriment among animal foods, but the price of butter
and eggs are apt to soar enormously during the winter
months.

Leguminous Food. — The dried pea, bean, or lentil are es-
pecially rich in protein, and are thus fit to take the place of
a part of meat in the dietary. Their price is low in com-
parison to their value, and must be considered next to bread

THE DIGESTIVE SYSTEM 123

in importance. They are less completely digested than
cereals if eaten in any quantity; and, highly nutritious as
these are, it cannot be denied that in large quantities they
are very indigestible for any but persons with strong con-
stitutions and leading an active outdoor life.

Great care is needed in their preparation. Dried leg-
umes should be soaked in cold water for eight hours, and
then boiled for one hour and a half. They are then suffi-
ciently soft to be pressed through a sieve. The skin of
peas and beans that have been dried should be removed, for
they pass through the intestines unchanged. Soft water
should be used in preference to hard, as insoluble lime com-
pounds are formed by the latter with the protein "legu-
min."

Outside Preparation Expensive. — From the standpoint of
food value, white bread is more than twice as costly as the
wheat flour from which it is made. A barrel of flour of 196
pounds will make on the average 315 5-cent loaves of
bread. The bread costs the consumer $15.75, whereas the
flour can be bought at the time of writing for $6.50.

Breakfast foods ready for the table, instead of the
cheaper cornmeal, oatmeal, and hominy cooked at home,
and bread, cake, and other pastry cost double the amount
of the raw materials.

There are, however, other factors which complicate and
increase the cost of living. At present the exorbitant cost
of labor, cost of fuel, etc., and the amount of the house-
wife's time consumed are all important factors to be taken
into consideration.

The size of the family, the number of small children de-
manding the mother's attention, the kind of labor in which
they are engaged, whether hired help has to be depended
on for all the work, etc., are all factors which must be taken
into consideration as to whether the outside preparation is
more expensive than when the labor is performed in the
home. This is a matter for every housewife to work out
in making her monthly and yearly budgets.

124

PERSONAL HYGIENE FOR WOMEN

TABLE OF FOOD VALUES »

Kind of food, edible
portion only.

Percentage composition.

Heat
value
calories
per
ounce.

Food
values
com-
parison
of 1000
grams.

Water.

Protein.

Fat.

Carbo-
hydrate.

Ash.

Meats.
Beef:
Roast, average

48.25
45.20
39.10
44.25
51.19
51.88

51.00
57.67

67.10

47.25
45.00

62.60
76.15
71.00

71.00
71.00

93.00
96.50
94.00
95.50
80.00
84.50
89.00
87.00
89.10
89.00
90.00

64.00
67.00
56.00
55.75
52.00
55.50
52.00
59.00
66.90
57.60

73.70
86.30
50.00

78.50
81.40

22.25
19.14
26.30
23.45
26.32
32.20

26.00
27.60

19.70
23.80
32.00

16.60
16.50
20.60

16.80
19.00

4.30
2.30
3.80
2.40
6.50
4.60
4.00
4.00
5.80
2.00
5.37

19.00
22.70
21.80
17.50
16.50
21.10
27.80
27.00
22.00
27.00

13.40
12.80
14.80

19.10
17.20

28.55
39.04
35.00
26.50
18.65
11.40

22.60
14.38

12.70
28.50
20.00

20.00
4.90
4.60

12.00
9.00

.50
.10
.10
.10
2.00
4.30
1.50
.80
1.50
1.50
.19

16.00
10.00
21.00
25.00
35.10
23.00
18.50
11.50
8.10
12.80

11.50
.20
33.70

1.20
.30

".40
1.80

1.10
.20
1.80
.30
9.00
5.50
4.30
8.50

5.50

1.25
.82
1.00
1.43
4.10
1.50

1.19
1.05

.80
1.25
1.76

1.00
1.20
1.50

1.60
1.00

1.10
.90
1.00
1.10
2.40
1.10
1.50
1.30
3.60
1.30
1.36

1.00
1.00
1.30
1.00
1.20
1.00
1.30
1.30
1.70
1.90

1.00
.70
1.20

1.20
1.10

160
122
175
100
80
68

90
67

66
100
90

70
32
38

51

46

8
3
6
3
24
23
13
15
11
12
7

65
62
91
95
110
85
82
60
58
80

45
16
106

27
21

1868
2057
2268
1942
1810
1896

1805
1738

1318
1966
2122

1370
940
1150

1157
1188

234
116
200
120
560
420
•278
291
324
158
269.

1130
1395
1656
1554
1800
1679
1872
1677
1298
1708

983
633
1883

935

922

Roast ribs, fat

Boiled, average

Broiled steak

Corned

Veal: Cooked, average

Mutton:
Roast, average.

Boiled leg

Lamb:
Roast leg

Various parts

Pork: Roast, various parts . .
Organs:
Heart, cooked, average
Kidney, ox, cooked, average
Liver, ox, cooked, average.
Sweetbread, ox, cooked,
average

Tongue, ox, cooked, aver-
age

Soup, etc.
Beef-tea

Bouillon

Chicken broth

Consomme

Meat hash

Meat stew

Oxtail soup

Pea soup

Soup stock, beef

Tomato soup

Meat juice (natural), average

Fowl.
Domestic, average

Chicken

Capon

Duck

Goose

Turkey

Roast

Roast capon

Chicken

Boiled fowl

Egg,.
Chicken eggs:
Baw

Boiled, white

Yolk

Fith and SheU-fiih.
Bluefish

Haddock, fresh...

Compiled from Tibbies' " Dietetics, or Food in Health and Disease. •

THE DIGESTIVE SYSTEM

125

Kind of food, edible
portion only.

Percentage composition.

Heat

value
calories
per
ounce.

Food
values
com-

parLson
of 1000
grams.

Water.

Protein.

Fat.

Carbo-
hydrate.

Ash.

Halibut steak...

74.80
74.80
80.00
75.70
63.60
56.30
70.60
71.20

77.70
69.30
70.80
77.50

87.30
90.30

62.40
20.00
26.40
74.00
90.00
45.30

13.00
16.00
16.00

10.50
10.80
8.60
10.90
12.50
12.40
72.50
84.50
78.40

44.10
49.10
47.20
38.20
24.00
5.80

42.50
66.00
62.40
60.00
60.00
64.50
70.10

92 JO

18.50
18.50
10.60
19.00
21.60
2480
18.50
21.00

19.30
18.30
17.80
4.50

3.50
4.00

10.60
10.50
10.40
2.50
3.20
32.00

1.00
2.00
1.10

11.90
12.20
12.60
10.20
7.10
6.90
2.80
2.80
3.00

7.70
7.40
7.70
9.30
11.50
9.80

3.10
2.60
4.20
5.50
4.00
3.30
.30

.50

5.30
6.50
2.60
4.00
13.90
12.70
9.50
3.80

2.10
10.60
10.20

3.70
.20

10.SO
9.90
.90
18.50
1.20
16.50

82.50
73.00
76.70

1.60
2.20
2.40
4.80
1.30
.40
.10
.50
1.50

.90
1.10
1.20
1.40
1.60
9.90

9.80
3.10
6.30
5.00
4.70
3.20
.10

.20

6.50
2.50

17.40

4.60
4.60

14.10
57.50
60.20
4.50
5.00
2.00

1.50
4.00

75.40
73.60
74.50
71.00
78.30
79.40
24.50
11.50
15.80

46.90
41.70
42.80
49.80
61.20
73.50

43.00
27.00
26.10
28.00
32.00
28.50
30.00

4.50

1.40
1.10
1.30
1.20
1.40
5.00
1.30
1.50

1.20
1.20
1.20
.70

.73
.83

2.00
2.10
2.10
.50
.60
4.20

2.00
5.00
6.30

.50

1.00
1.70
1.30
.60
.50
.20
.70
1.30

.30

.50
.90
1.30
1.70
1.00

1.80
1.00
1.00
1.40
.60
.80
M

.80

35
40
25
33
64
79
47
38

28
48
48
26

20
11

52
100
40
56
10
85

225
203
220

114
114
116

ios

102
45
18
26

71
65
67
72
90
125

80
36
52
51
52
45
30

8

850
1086
655
1049
1445
1560
1170
1252

995
1190
1156
210

320
245

973
1368
1232
210
238
2140

2371
2235
2210

1283
1300
1330
1242
1106
1084
258
244
558

793
770
780
910
1126
1399

866
456
604
628
608
505
289

70

Mackerel

Oysters

Salmon, Atlantic

Sardines

Shad...

Roe

Trout:

Brook

Ukv

{Union

Calf's foot jelly

• MM Producti.
Cows' milk, average

Skimnvd

Condensed milk, full cream,
unsweetened
Full cream, sweetened.. .
Skimmed and sweetened.
Cream, hand skimmed

Buttermilk

Cheese from skimmed milk . .
Butter:
Best quality
Second quality ....

Margarine!

Cereal Food*.
Wheat flour, superfine, white.
Entire wheat

Graham

Maiie ....

Mral

Rice...

Boiled. .

Oatmeal, boiled

Macaroni, cooked

Bread.
White, best

Entire wheat

Brown (Graham)

Gluten bread

Toasted bread

Zwicbach ..

Pitt and Puddingi.
Apple pie

Cornflour Wane mange
Custard with crust

Maiie pudding (Indian meal)

Tapioca pudding

' With apples

RooU and Tvben.
Carrot*, boiled...

126

PERSONAL HYGIENE FOR WOMEN

TABLE OF FOOD VALUES (Continued).

Kind of food, edible
portion only.

Percentage composition.

Heat
value
calories
per
ounce.

Food
values
com-
parison
of 1000
grams.

Water.

Protein.

Fat.

Carbo-
hydrate.

Ash.

Roots and Tuber ».

91.70
92.10
75.50
75.10
2.20

91.60
93.70
85.50
97.00
97.30
97.00
73.80
89.20

94.50
94.90
93.00
93.80
87.60
91.80
91.80
92.80

9.50
12.60
10.50

4.80
5.40
4.50
4.80
19.20
48.00
9.20
4.90

85.20
66.10
28.10
85.00
81.40
75.70
86.30
82.00
88.90
20.00
22.70
80.50
18.60
30.50

1.40
1.30
2.50
2.60
6.80

2.10
1.50
2.30
.60
.60
.40
6.70
2.30

1.10

.70
1.00
1.80
1.60
1.20
1.20
.70

23.80
22.50
20.60

21.00
18.00
28.00
11.60
5.40
8.00
26.00
15.50

.40
.20
1.60
1.10
.90
1.30
1.30
.90
.50
3.50
4.30
.90
3.00
1.50

.10
.30
.10
3.00
39.80

3.30
.10
.70
.10
.10
.07
2.50
.30

.10
.20
.10
.60
.30
.10
.10
.40

1.80
1.90
2.00

54.90
66.00
61.00
15.30
51.00
28.50
38.60
62.70

.50
.80
2.20

".50
1.00
.80
.60
2.30
.70
.80
2.80

5.13
6.50
21.00
17.80
46.70

2.20
3.40
5.10
1.40
1.40
1.00
14.60
7.40

9.70
3.10
3.00
4.80
9.50
5.60
5.60
4.00

60.30
59.60
62.60

17.30
8.00
3.50
65.70
10.00
11.50
24.20
7.50

12.60
37.20
66.10
13.40
17.30
21.70
8.40
14.30
4.00
69.00
'62.50
14.70
70.50
[60.00

1.00
.70
1.00
1.50
4.50

.80
.20
1.70
.20
.50
.50
1.50
.80

1.00
.50
.60
1.20
1.10
.70
.70
1.20

2.60
3.50
4.20

2.50
2.70
2.90
2.60
1.20
1.50
2.00
1.90

.30

.70
2.00
.50
.40
.70
.50
.60
.20
1.30
1.30
.50
2.70
.50

11
11
26
31
166

30
6
9
3

'34'
12

13
4
8
9
13
5
5
6

104
100
102

189
204
192
117
108
160
160
190

18
46
84
18
21
29
17
23
14
101
80
28
100
10

102
126
312
364
1807

200
98
89
41
41
26
588
176

144
64
73
138
167
107
107
79

1544
'1654
1519

2645
2606
2956
1537

2071
2364

149
395
753
176
208
276
120
197
76
885
805
201
870
744

Potatoes, boiled

Fried in fat

Vegetables.
Asparagus, cooked and but-
tered

Cabbage

Boiled

Salads.
Celery

Endive

Lettuce

Radishes

Tomatoes

Dried Legumes.
Peas

Butter beans

Nuts.
Almonds, dried

Brazil nuts

Butter nuts

Chestnuts

Cocoanut, fresh

Hazel and filbert nuts

Peanuts

Walnuts dried

Fruit*.
Apples:
Raw ...

Cooked and sweetened . . .
Dried

Apricots

Canned

Bananas

Blackberries

Cherries

Cranberries

Dates, dried

Figs, dried

Grapes, fresh

Dried, raisins

Jam, or preserve, average. . .

THE DIGESTIVE SYSTEM

127

Peroenb

ige compt

Mitioo.

Heat

Vlllll-

Food
values

Kind of food, edible
portion only.

Water.

Protein.

Fat.

Carbo-
hydrate.

Ash.

calnrics

per
ounce.

Com-
pun- ,11
of 1000
grams-

Fmitt.
Melon

89.50

.00

JO

720

60

11

103

Oranges...,

s.' ->0

.90

.20

10 60

70

16

140

Fetches

^ MJ

.50

20

9 20

60

12

117

Canned. . .

88.10

.70

.10

10 80

30

14

128

Pears

80.90

.90

.50

15 70

40

18

203

Gnatd

81.10

JO

.30

1800

30

22

195

Pineapples

89.30

.40

JO

1000

90

13

112

Plum.

74.50

.90

.20

19 10

50

24

200

Prunes:
Mad

2230

2 10

20

73 30

2 30

80

724

Stewed

76 60

.50

10

22 30

50

27

243

Raspberries

SO "1)

50

5 60

'so

16

70

Strawberries

94 00

1 00

60

8.80

60

12

144

The Physiologic Action of Moderate Doses of Al-
cohol.— The result of a series of experiments by Dr.
Parke were as follows: "By quickening the action of the
heart, it shortens the interval of rest, and, therefore, in-
terferes with the nutrition of the heart. It also produces
palpitation and breathlessness. Even small doses of
alcohol, by increasing unnecessarily the action of the heart,
are injurious. It acts on the nervous system by lessening
the rapidity and the delicacy of the impressions, as well as
by lessening the power of control of a train of thought.
Further, by this same blunting of the nervous system,
voluntary muscular power is impaired, and the finer
combined movements are less perfectly made. It causes
a lowering of the temperature of the body, and, although
it is taken to overcome the effects of exposure to cold, it
has been learned that persons who take it are less able to
resist the exposure to cold."

As the result of modern scientific investigation and ex-
perimentation, alcohol with its compounds has been taken
out of the list of beverages, where it has heretofore been
classified with tea and coffee, and out of the list of foods,
to which class it had been admitted because of the known
oxidation of alcohol in the body, and has been placed hi
that list of drugs known aa narcotics, alongside of ether,

128 PERSONAL HYGIENE FOR WOMEN

chloroform, opium, and cocain — all of them, the most
deadly drugs in the Pharmacopeia, yet, when used by
skilled hands, the most beneficent.

The first effect of this class of drugs is a short temporary
stage of exhilaration, more or less rapidly followed, ac-
cording to the amount taken, by a stage of sleepiness or
actual insensibility, which lasts longer than the stage of
excitement, and this in turn is followed by a long period of
depression.

Like other members of its class, alcohol has a cumula-
tive action, the residual quantities habitually taken ac-
cumulate and gradually affect the efficiency and well-
being of the individual.

A point that must always be borne in mind in giving
any medicine is that not a few drugs have a curious ten-
dency to induce a craving for their repetition.

The amount of alcohol contained in some of the most
commonly used of the alcoholic beverages is as follows:
beer, 4 to 5 per cent. ; hard cider, from 5 to 10 per cent. ;
claret, 8 to 1 1 per cent. ; port, 9 to 22 per cent. ; champagne,
10 to 15 per cent. ; rum, gin, and strong liquors, 40 to 60
per cent.; whisky, 44 to 50 per cent.; brandy, 48 to 56
per cent.

These alcoholic beverages are often made still more
harmful by adulterations by ingredients in themselves
harmful.

A large percentage of alcohol is also found in bitters
and patent medicines.

We will consider the subject of alcohol under the fol-
lowing aspects: First, the question of alcohol as a food;
second, the effects of alcohol on the digestive system and
the metabolism; third, the effects of alcohol on the heart
and the muscular system; and fourth, the effects of alcohol
on the nervous system.

First, Is Alcohol a Food? — The substances used as foods
act in providing energy for muscular work, in maintaining
the heat of the body, in building up of the tissues, and in
saving the waste of the tissues. Moreover, a food which

THE DIGESTIVE SYSTEM 129

does harm to any organ, or to the system as a whole,
when taken in moderate repeated quantities, becomes a
poison for that individual.

A food may be defined as any substance which, when
absorbed into the blood, will nourish, repair waste, and
furnish force and heat to the body, without causing
injury to any of its parts or loss of functional activity.
From any one of these four standpoints alcohol cannot be
regarded as a food.

The physiologic effects of alcohol and real food-stuffs
are totally different. Fats, carbohydrates, and nitroge-
nous foods after mastication at once begin to be digested
and assimilated, and to fulfil the true functions of a food
by maintaining a natural temperature, pulse-rate, and
tissue repair of the body, without any disturbance of its
mental and physical functions and activities.

Alcohol, on the contrary, is absorbed from the stomach
unaltered by the digestive processes; circulated in the
blood in its original form, it at once interferes with the
ordinary activity of the brain and other organs, and,
by its anesthetic action, hampers the mental and phys-
ical activities and interferes with the processes of meta-
bolism.

The Effects of Alcohol on the Digestive System and
Metabolism. — The local action of alcoholic liquids is
particularly destructive on an empty stomach; and when
taken in strong solution, but it is also known that smaller
doses, taken continuously, are liable to effect the digestive
organs in a slower though similar way.

The injurious effects of alcohol are that it acts as a local
irritant, producing dilatation of the blood-vessels of the
stomach and subsequent gastritis; it leads to hyperacidity,
by stimulating the secretion of hydrochloric acid; the
tartrates and malates contained in wine are decom-
posed in the stomach, setting free organic acids, and
thus producing acidity; the acetic acid and yeast in
beer set up an acetic acid fermentation in the stomach-
contents.

130 PERSONAL HYGIENE FOR WOMEN

Whether taken alone or with food, the tendency of alco-
hol throughout is to lessen the churning movements of
the stomach, and leads to atony of that organ, which
in turn leads to dilatation of the stomach.

Alcohol appears to have a particularly deleterious effect
on the digestion of women. This is explained by the fact
that men lead a more active outdoor life, and consequently
retain their appetite for food longer than women. For
the same reason, they are able to work off the effects of
drinking more easily and start afresh the assimilation of
food. The indoor life led by women, their clothing,
worn tight around the stomach, are added causes for
lack of appetite. Catarrh of the stomach results; this is
followed by insufficient food and an increased amount
of stimulants. There follow nausea, irregular and insuf-
ficient nutrition, indigestion, and a faulty elaboration of
the food.

By its action on the liver alcohol interferes with the
amount and quantity of bile, and so inevitably leads to
indigestion and constipation, and a similar interference
with the action of the liver-cells and their chemical
changes set up in many cases gouty conditions, accom-
panied by mental depression and irritability.

Diseases of the liver occur more frequently as the result
of taking frequent small doses of alcohol, though never
reaching the stage of intoxication, than as the result of
indulging more freely, but at longer intervals.

The Effect of Alcohol on the Blood. — The blood is a mix-
ture of corpuscles and a fluid known as the blood plasma.
The corpuscles are of two kinds — red and white. The red
blood-corpuscles are the oxygen carriers; they carry the
oxygen to the tissues, where they readily give it up. They
are constantly being destroyed by the liver and spleen,
and are replaced by new ones, which come from the red
marrow of bones. The white corpuscles are much fewer
in number, but they play a most important part in pro-
tecting the body against disease. It is now about twenty
years since Professor Metchnikoff, of the Pasteur Institute

THE DIGESTIVE SYSTEM 131

of Paris, announced to the world his discovery that the
white corpuscles have the power of destroying the mi-
crobes to which so many diseases are due. These white
blood-cells form the standing army or policemen of the
body, and their duty is to attack, and, if possible, to
destroy, any foreign matter, such as dust or disease
germs.

The plasma of the blood contains various kinds of salts,
and include sodium chlorid or common salt, the phos-
phates, and chlorids of calcium and potassium.

The way which the body fights disease is partly by means
of the white blood-corpuscles, which totally destroy the
germs, and partly by the increase in the blood of those
chemical substances which are antidotes for the poisons
given out by the germs.

Alcohol taken into the stomach is quickly absorbed and
reaches the blood in two minutes. The maximum of
alcohol is found in the blood in fifteen minutes after it is
swallowed.

The blood is the medium by which food and oxygen are
conveyed to the tissues, and by which the refuse material
from the tissues is carried away; alcohol interferes with
both these processes.

The red cells are liable to become damaged and anemia
results. It has now been proved that even tiny doses of
alcohol paralyze more or less the white cells, and thus in-
terfere with their power of destroying microbes. Chemi-
cal substances tend to exert a delaying or inhibitory in-
fluence over the chemical processes of the body. These
chemical processes are oxidation, the storing up of nutri-
ment, the manufacture of secretion, the production of
energy and muscular movement, and the excretion of
waste materials.

The greatest possible difference exists as to the rate at
which oxidation goes on. When there is nothing to hinder
its occurrence, the poisonous toxins and waste matters
are rapidly burned up and eliminated and health prevails.
Alcohol, by its affinity for oxygen, robs the tissues of

132 PERSONAL HYGIENE FOR WOMEN

oxygen which they would otherwise use for combustion.
Hence the tissues are kept starving for oxygen, metabo-
lism is interfered with, and they cannot get rid of their
waste material.

This delayed oxidation tends to increase the body
weight. The cells in an intermediate stage of fatty degen-
eration clog the body, and, of course, add to its weight.
The natural effect of taking alcohol is to make the body
obese. On abstaining from alcohol, the superfluous
tissue is often burned away, and the weight of the body
reduced, and a look and feeling of youth is recovered.

The Effect of Alcohol on the Heart and Circulation. — By
the circulation we understand the driving of the fluid
blood around the body, through the blood-vessels, such
driving being maintained by the pumping power of the
heart, which is practically a hollow muscle.

In consequence of this pumping power of the heart, the
blood in the vessels is under considerable pressure, which
is naturally increased if the blood-vessels are narrowed
or contracted, and diminished if the blood-vessels are
expanded or dilated.

Gradual deterioration in the heart power is a cause of
premature death. One of the early indications that the
foregoing changes may be occurring in a heart is a sense
of fatigue and breathlessness on slight exertion, or a
feeling of disinclination for normal effort. The result of
such depression of the efficiency of the heart is often seen
when the individual is attacked by some disease; she
succumbs to heart failure, instead of being able to resist
the disease. This probably accounts for a great many
deaths between forty and sixty years of age.

Further, it must be remembered that all the nutritive
action of the blood depends on its power of rapidly
filtering through the walls of the blood-vessels to the
tissues, and, conversely, its power of drawing off the
waste-products of the tissues depends on the facility with
which such products can penetrate its walls.

As soon as degeneracy sets in, the walls of all vessels

THE DIGESTIVE SYSTEM 133

tend to become thickened, and the active transference
through them, more and more prevented; the nutrition
of the body is thus gravely hampered, and, with the
advance of this thickening of the walls, the vessels are less
able to adjust themselves to the variations in pressure
from within; and, finally, when unable to withstand the
pressure, they rupture, causing hemorrhage and apoplexy,
which, when occurring in the brain, cause paralysis and
mental decay.

A similar degeneration takes place in old age, but the
point is, that many persons, instead of waiting until old
age comes to them, deliberately precipitate these senile
changes.

The Effect of Alcohol on the Kidneys. — The elaborate
mechanism of the kidneys consist of a filtering system of
thousands of tubules, arranged closely side by side, whose
function it is to carry away from the body the waste
material, which otherwise would interfere with the vitality
of the different organs.

The part played by the kidneys in rapidly eliminating
effete material cannot be too carefully safeguarded.
Anything which interferes with its work will sooner or
later cause a retention of waste-products in the system,
and will also permit of the escape of valuable albuminous
materials of the substance of the blood through the filter-
ing apparatus. The effect of alcohol upon the kidneys
can only be described as disastrous. In proportion
as the kidney shrinks, there is a diminution of the excre-
tion of urine, and, finally, the condition known as Bright's
disease is established.

The Effect of Alcohol on the Muscular System. — The
muscular tissue forms 43 per cent, of the body weight.
It has been proved that under the moderate use of alcohol
the muscles become flabby and less vigorous and effective;
that troops cannot work or march on alcohol; that in
training for athletics, for races, or for other sports, total
abstinence is always practised; the true sportsman de-
pends quite as much on his brain as on his muscles for

134 PERSONAL HYGIENE FOR WOMEN

success. In England it is recognized that total abstinence
is a necessity where great exertions are concerned, and it
is now beyond all question that alcohol, in even so-called
dietetic quantities, diminishes the output of muscular
work, both in quantity and quality, and that the best
physical results are obtained under total abstinence from
its use.

Alcohol actually lowers the temperature of the body
from three-fourths of one degree to three degrees. This
depression of temperature is not transient, but lasts for
several days, so that its use, when the person is exposed
to intense cold, is extremely hazardous to life.

The Effects of Alcohol on the Nervous System. — Kraepelin
has carried out a series of experiments to prove the effects
of small doses of alcohol on the output of work. In all
mental work there are two elements to be considered,
namely, quality and speed. Now, all observers are
agreed that the quality of mental work is affected even
before speed, more mistakes being made. Tests were
made in reading aloud; in adding figures in various com-
binations; in type-setting; and in memorizing; in all
these instances it was found that, after taking moderate
doses of alcohol for a number of consecutive days,- the
work done was less, was less accurate, and that there
was a decrease in the power of memorizing.

Another series of investigations, made by Rudin to
determine how long the intellectual abilities continue to
be depressed after the effects of alcohol pass off, showed
that the effects of a single dose of alcohol persisted until
noon or evening of the next day.

Von Helmholtz, one of the greatest observers and
thinkers of the nineteenth century, noted on himself the
effect of alcohol in interfering with the highest powers
of thought and conception. Describing the conditions
under which his highest scientific thoughts had matured
and come to fruition, he said: "As far as my experience
is concerned, they never come to a wearied brain or at the
writing-desk; they were especially inclined to appear to

THE DIGESTIVE SYSTEM 135

me while indulging in a quiet walk in the sunshine or
over the forest-clad mountains, but the smallest quantity
of alcohol seemed to drive them away."

Professor Sikovsky's testimony is that "alcohol dimin-
ishes the rapidity of thought, makes the imagination and
the power of reflection commonplace and deprived of
originality, acts upon fine and complex sensations by
transforming them into coarse and elementary ones,
provokes outbursts of evil passions and dispositions, and in
this predisposes men to strife and crime, and upsets
habits of work and perseverance."

Self-control is one of the highest functions of the brain,
and the racial power which results to a people as a conse-
quence of the individual practice of self-control cannot be
too highly estimated. Therefore, children are trained as
far as possible to control their emotions and actions.
Alcohol diminishes and breaks down this power of ac-
quired self-control, undoing the work of parents and
educationalists. Quite small doses are often responsible
for reckless and self-pleasing actions, which are far
reaching in their results in loss of moral tone and self-
respect. The ideals of duty are lost sight of, and, at best,
leave the individual in a laissez-faire attitude. Among
the depressant effects of alcohol are intellectual lethargy
and a sense of fatigue, which, combined with the other
factors, lessen the capacity for genuine enjoyment and
pleasure.

CHAPTER V

\

THE RESPIRATORY AND CIRCULATORY SYS-
TEMS: THE KIDNEYS

The Mechanics of Circulation and Respiration; the Circulatory
Apparatus; the Lungs; Hygiene of the Lungs and Its Relation to the
General Health; Relation of Respiration to Body Heat; the Res-
piratory Functions of the Abdominal Muscles; the Importance of
Good Chest Development; Proper Relation Between the Height,
Weight, and Chest Measurements; Chemical Properties of Air;
Town and Country Air; Dust and Its Relations to Disease; R61e
Played by Bacteria; Ventilation; the Injurious Effects of Overheated
Air; the Proper Degree of Moisture for tne Air of the House; Ventila-
tion of Bed- rooms.

Care of the Nose, Throat, and Ears; Impediments to Respiration;
Ventilation of the Lungs and Breathing Exercises; Cure of Chronic
Bronchitis by Deep Breathing Exercises; Relation of Colds to
Pneumonia and Tuberculosis, and Their Prevention.

The Kidneys and Their Function; the Physiology of the Female
Pelvic Organs.

IT is said that diseases of the lungs are the cause of
four-fifths of all indispositions, ill health, and actual
disease among civilized people, and that, between the
age of fifteen and twenty-five, almost one-half of the
mortality is due to pulmonary tuberculosis.

This almost universal weakness of the lungs, as it may
be styled, is a product of modern civilization, and is
caused by our unhygienic mode of life. Too little im-
portance is attached to physical development, and well-
developed lungs can only be found in a well-developed
chest; too little time is spent in outdoor exercise; and
private houses, public conveyances, and public assembly
rooms are not properly ventilated.

Good development of the chest and lungs, and thorough
and systematic ventilation of the lungs, are essential to a
strong heart, a vigorous circulation, and power of the
tissues to resist disease.

137

138

PERSONAL HYGIENE FOR WOMEN

The Mechanics of Circulation and Respiration. —

In order to understand the mechanics of circulation and
respiration, it is necessary to appreciate four funda-
mental facts — that the thorax is a distensible, air-tight
cage; that it contains and is filled by the heart, lungs,
and great blood-vessels; that the exchange of gases in the
blood takes place in the lungs; and that, on the develop-
ment of the chest and respiratoiy muscles, depend the
development of the lungs and the force of the circulation.

f/y ribs
Fig. 7. — The bony thorax, anterior view (Ingals).

The Thorax. — The chest or thorax is a cone-shaped,
distensible cage, formed of bones, elastic cartilage, and
muscles. The spinal column forms the fixed part of this
living cage, and the ribs are attached to this in such a
way as to allow of their being raised in inspiration, thus
increasing the anteroposterior and the lateral diameters
of the chest.

The thorax is converted into an air-tight cavity by

THE RESPIRATORY AND CIRCULATORY SYSTEMS 139

means of muscles. The base is made up of one huge
muscle, the diaphragm. This is attached at its border to
the ribs and posteriorly to the backbone. It is the dia-
phragm which separates the cavity of the thorax from that
of the abdomen. When the diaphragm is relaxed, it has
a concavoconvex form, the convexity being directed
toward the chest, and the heart and lungs rest directly
on it, while the concave surface covers or rests on the
liver.

The Circulatory Apparatus. — This consists of a central
force and suction-pump, the heart, and a series of elastic
tubes that grow smaller the further from the heart they
are situated; they divide and subdivide, like the branches
of a tree. The smallest arteries, called capillaries, from
their hair-like size, are so minute that they only allow
the passage of a single corpuscle at a time and their walls
are transparent.

The heart is a somewhat cone-shaped organ, placed
between the two lungs; it is situated more or less obliquely
in the chest, immediately back of the breast-bone.
Roughly speaking, the base of the heart corresponds to
the right edge of the sternum, while the apex lies a little
below and to the right of the left nipple.

The heart is divided into a right and left side. The
left side forms the force pump, whose motive power is
supplied by the contraction of its own muscle-fibers.
The bright red blood, with its fresh supply of oxygen —
hence its color — flows from the lungs into the left heart,
which then contracts automatically and forces the blood
into the arteries of the body.

The arteries consist of a series of elastic tubings ; hence,
the smaller the tubing, the greater the resistance which
has to be overcome by the force of the heart's beat, so
that during violent exercise, when the contraction of the
muscles causes a pressure on the minute arteries and
capillaries situated in them, the more forcible must be the
beat of the heart to overcome this additional resistance.
Likewise, when the surface of the body is suddenly

140

PERSONAL HYGIENE FOR WOMEN

chilled, as by a plunge into cold water, all the vessels
situated here contract, and, again, more work is thrown
on the heart.

The three chief factors in the mechanics of the circula-
tion are the force and frequency of the heart's beat, the
peripheral resistance, and the elasticity of the arterial
walls. Any disturbance between these relations brings
about abnormal conditions.

Larynx

Right common

carotid artery

Subclavian

arteries

Innominate

artery

Arch of aorta
Right lung

Superior vena
cava

Right auricle

Heart

Coronary
artery

Fig. 8. — Front view of heart and lungs, showing relations to other
thoracic organs (Ingals).

The average frequency of the heart's beat, or the pulse,
is 72 times a minute. It is increased by exercise; it is
quicker in the standing than in the sitting posture. It
is quickened by meals, and, on the whole, it is quicker
in the evening than in the early morning hours. Inde-
pendent of muscular exertion, it is quickened by great
altitudes. It is said to be quicker in summer than in
winter. Its rate is profoundly influenced by mental con-
ditions.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 141

The whole of the blood of the body passes through the
heart in 32 beats — that is, in less than half a minute.
The greatest part of this time is spent in the capillaries,
There the tissues are obtaining their fresh supplies of food
and discharging their waste matter into it.

The heart, great blood-vessels, and the lungs are placed
in the air-tight cavity of the thorax, and are subjected to
the pumping action of the respiratory movements. The
inspiratory muscles elevate the ribs, at the same time that

Fig. 9. — Relation of heart and great vessels to the wall of the thorax.
The collapsed lungs are drawn slightly aside (after Heath).

the diaphragm, by its contraction, pushes the contents of
the abdomen downward. The cavity of the chest, so
enlarged, causes the pressure around the heart and the
great blood-vessels within the chest to be less than that
on the blood-vessels outside the chest ; hence, during each
inspiration the venous blood is sucked back into the right
side of the heart.

The tissues deprive the blood of its oxygen, so that which
flows back to the heart in the veins is blue. The right

142 PERSONAL HYGIENE FOR WOMEN

heart then sends this blue blood to the lungs, that it may
get rid of its carbonic .acid, which is not only not needed,
but is actually injurious to the body, and to receive a fresh
supply of oxygen, which has been carried into the lungs in
breathing.

The blood is the great medium of exchange between all
parts of the body. It is, at the same time, the nourisher
and the scavenger of all the tissues. After the food has
been liquefied and converted into new substances in the
digestive system it is poured into the blood. From the
blood all the tissues draw material to renew their own
worn-out parts and other material which they store up

Fig. 10. — The diaphragm (after Kitchen).

as latent force, which, when it unites with the oxygen of
the blood, becomes active force, such as heat and motion.

The blood holds in suspension a vast number of minute
cells or corpuscles; the red corpuscles give its color to the
blood, and are the oxygen carriers, while the white are the
phagocytes or the protective agents of the body against
disease.

The blood constitutes about one-thirteenth of the body
weight. Of this, one-fourth is distributed to the heart,
lungs, and great blood-vessels, one-fourth to the liver, one-
fourth to the skeletal muscles, and the remainder to other
organs.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 143

In order that the blood may be a satisfactory medium
of exchange between all the tissues of the body two things
are necessary — first, there must be through all parts of
the body a flow of blood of a certain rapidity and general
constancy; and, second, this flow must be susceptible
of general and local modifications.

The lungs are the essential organs of respiration or
ventilators of the body. They are two in number, separ-
ated from each other by the heart, are placed in a semi-
distended state in the air-tight thorax, which we have
seen they, together with the heart and great blood-
vessels, completely fill. The lungs ultimately consist of
air-cells, surrounded by dense plexuses of capillaries and
nerves. The air-cells communicate with the exterior
through the bronchial tubes, trachea, larynx, throat, and
nose.

The larynx is the organ of voice. It is situated be-
tween the trachea and the base of the tongue, at the upper
and back part of the neck, where it forms a considerable
projection in the middle line, called Adam's apple.

The trachea is a cylindric tube, which extends from the
larynx downward about 4J inches, when it divides into the
right and left bronchial tubes. The bronchial tubes, on
entering the lungs, divide and subdivide, until finally they
terminate in a lobule which is composed of air-cells and
intercellular passages.

In inspiration the cavity of the thorax is enlarged by
an active contraction of the muscles, in consequence of
which the pressure of air within the lungs becomes less
than that of the air outside of the body, and this differ-
ence of pressure causes a rush of air through the trachea
into the lungs, until an equilibrium of pressure is estab-
lished between the outside air and that within the lungs.
This constitutes inspiration. Upon the relaxation of the
respiratory muscles, the elasticity of the chest-walls and
lungs, aided perhaps, to some extent, by the contraction
of certain muscles, causes the chest to return to its original
size. In consequence of this, the pressure within the

144 PERSONAL HYGIENE FOR WOMEN

lungs now becomes greater than that outside, and the air
rushes out of the trachea, until the equilibrium is once
more established — expiration.

During quiet respiration all parts of the lungs are not
equally expanded; it is chiefly the apices of the lungs,
reaching up into the region of the neck, and the central
parts of the lungs, which undergo the least change of
volume. This lack of a thorough distention and aeration
of every part of the lungs is a cause of weakness of the
lungs as well as of the entire body, for it is precisely
those parts of the lungs which are the least active that are
most prone to become the seat of tuberculosis.

In forced inspiration the cavity of the thorax is in-
creased from 2 to 3 inches, partly by the elevation of the
ribs and partly by the descent of the diaphragm, due to
the contraction of its muscular fibers. In contracting,
the diaphragm presses upon the abdominal viscera, push-
ing them downward about 3 inches, so that a projection
of the flaccid abdominal walls occurs. The movements of
the diaphragm are less extensive in women than in men,
which is believed to be due to the corsets and general
manner of dress. A perfectly free mobility is necessary
for change in the size of the chest and lungs, in which the
respiratory movements take place from sixteen to twenty
times a minute.

The amount of air entering and leaving the lungs varies
greatly in ordinary and forced respiration, being often
three times as much in the latter. The volume of air is
determined by the spirometer. Mr. Hutchinson, who
invented the spirometer, has defined the vital ca-
pacity of the lungs as that amount of air which can be
expelled by the most forcible expiration, and so the meas-
ure of the individual's respiratory power. The vital
capacity varies according to a number of conditions, as
age, sex, weight, but, most important of all, is the height.
It has been found that between five and six feet the vital
capacity increases eight cubic inches for each inch in
height.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 145

The vital importance of the r61e which oxygen plays
in the health and life of the individual may be better
understood from the facts that about 10,000 liters of air
are breathed daily, which makes the amount of food and
drink consumed daily seem almost infinitesimal, and,
important as the quality of the food is, the quality of the
air is much more so, and, finally, that one can live for some
days without either food or drink, but dies in a few min-
utes if the supply of air is cut off.

Secretion of the Lungs. — Like the lips and mouth, the
lungs are invested on their free inner surface by a delicate
mucous membrane, which constantly secretes a clear
viscous fluid, the mucus. The lungs, therefore, like the
nose, are always moist, and just as the nose is cleared by
blowing it, so the lungs are cleared by hawking or cough-
ing. A sense of discomfort or a feeling of irritation of the
windpipe induces a deep inspiration, followed by an
explosive expiration, which quickly brings up the mucus,
so that it can be expectorated. The only difference be-
tween the mucus of the lungs and that of other organs is
that the former is mixed with air and has, therefore, a
frothy appearance.

The secretion of the lungs naturally flows down and
accumulates, until it is voluntarily brought up and ex-
pelled. Any one with a cold on the chest, or who is sub-
ject to catarrh, will notice that, on moving about in the
morning in making the toilet, especially on raising the
arms to dress the hair, expectoration is greatly facili-
tated, and that this is followed by a feeling of clearing
out of the throat and lungs.

Because of the great aid given to the lungs in clearing
them of mucus, moderate exercise in the open air is a
much better treatment of an ordinary cold than a pro-
longed stay in bed. And for the same reason, in the treat-
ment of lung troubles, so soon as the temperature of the
patient is down to normal, and her strength makes it safe
to allow her to move about, the recovery of the patient
is hastened by getting up and moving about the house.
10

146 PERSONAL HYGIENE FOR WOMEN

Hygiene of the Lungs and Its Relation to the
General Health. — Two conditions are essential for the
preservation of the health and prevention of diseases of
the lungs — good chest and lung development, and a con-
tinuous supply of fresh air for the proper ventilation of
the lungs.

Fully one-third of the whole volume of blood is
always circulating in the lungs, and each corpuscle passes
through them 8000 times in the twenty-four hours. In
other words, the lungs are the vitualizing stations of the
corpuscles which unceasingly go hurrying by. If these
carbonic-acid-laden corpuscles arrive in the lungs, and do
not find the requisite amount of oxygen awaiting them,
they return to the tissues, carrying part of their carbonic
acid back to them instead of a fresh supply of oxygen,
and so the tissues are weakened instead of being nourished,
while the corpuscles themselves suffer from lack of proper
nourishment and deteriorate in form and color. Imper-
fect ventilation of the lungs is the most frequent cause of
anemia or thinness of the blood.

It must not be overlooked that the air may be fresh and
pure, and yet not able to penetrate all parts of the lungs
because of superficial and improper breathing.

Relation of Respiration to Body Heat. — The heat
of the body is generated by the oxidation of the tissues.
The chilliness experienced by persons engaged in seden-
tary occupations is by no means always caused by the
low temperature of the room, as will be proved by the
thermometer, but by the close air of the room and super-
ficial respiration, which causes internal overheating with
imperfect combustion. The correctness of this state-
ment may be proved if the woman will throw the win-
dows wide open and take deep breathing exercises for five
minutes. She will then go back to her work thoroughly
comfortable. In other words, she has breathed herself
warm.

The Respiratory Function of the Abdominal Mus-
cles.— Woll-developed abdominal muscles play an im-

THE RESPIRATORY AND CIRCULATORY SYSTEMS 147

portant part in expiration, hence, in emptying the lungs
of their impurities. Under normal conditions the pres-
sure in the abdominal cavity is greater than that of the
atmosphere; hence in the elastic recoil following inspira-
tion, the abdominal viscera constitute a buffer, so to
speak, and drive the diaphragm upward.

The chief causes of flabby abdominal muscles, with its
consequent low intra-abdominal pressure, are a sedentary
life, the wearing of corsets which prevent the free play of
the abdominal muscles, and the overdistention of the
abdominal walls by repeated pregnancies and by the
accumulations of fat.

As a result of lax abdominal walls, there is very fre-
quently an enteroptosis or a falling of the abdominal con-
tents far below their normal position; this includes the
liver, spleen, pancreas, the intestines and stomach, and
is the most frequent cause of floating kidney.

Further, the accelerating influence of the diaphrag-
matic movements on the circulation is seriously interfered
with.

The Importance of Good Chest Development. —
The least chest development of the adult woman — that
is, the underarm girth around the chest — consistent with
good health is 28 inches, and this girth must be enlarged
3 inches on forced inspiration. In ordinary respiration
the waist expansion should be from $ to 1 inch, while dur-
ing muscular activity it should be from 1$ to 3 or 4 inches.

In women the movements of the upper part of the chest
are very conspicuous, the breast rising and falling with
every respiration; whereas, in children and in men the
movements are almost wholly confined to the lower part
of the chest, and are called diaphragmatic, in contradis-
tinction to those seen in women, which are called thoracic.
It is now the opinion of many observers in this country
and in Europe that the habit of thoracic breathing hi
women has been brought about by constricting the waist
and the lower ribs. Observations made among the In-
dians and Chinese women show that the abdominal is

148 PERSONAL HYGIENE FOR WOMEN

there the type of breathing, and civilized women who
wore no corset had relatively good abdominal breathing.
Further, that a thoracic type of breathing can be pro-
duced in man by putting him in a corset.

Vital capacity is, as we have seen, the term employed
to denote the amount of air that can be expired after the
fullest possible inspiration. The amount for persons
5 feet in height has been estimated as 174 cubic inches,
with an increase of 8 cubic inches for every inch in height
above this. The relation between height and vital capac-
ity is rather remarkable, since height is chiefly determined
by the length of the legs, and not by the size of the trunk
and thorax. This is due to the fact that mobility of the
chest increases with stature.

The capacity of the chest is determined by the spirom-
eter. A person who can only blow, say from 180 to
250 cubic inches, has a good pair of lungs, while, on the
other hand, an ability to blow only 100, even where per-
cussion and auscultation had revealed nothing, is sus-
picious.

One test by the spirometer is not sufficient to judge of
the condition of the lungs, since the woman may be ner-
vous or may not understand how to breathe into it, so
that a number of tests should be made on different days,
which may give a much better result, though no change
has occurred in the lungs.

Proper relation between the height, weight, and chest
measurement :

Height. Average weight. Average chest measurement .

Feet. Inches. Pounds. Inches.

5 120 29.80

5 1 122 30.60

5 2 125 35.00

5 3 128 35.75

5 4 131 36.25

5 5 135 37.00

5 6 139 37.50

5 7 143 38.00

5 8 147 38.50

5 9 151 39.00

THE RESPIRATORY AND CIRCULATORY SYSTEMS 149

The Chemical Properties of Air. — It is of more vital
importance that the air which we breathe should be pure
than the food which we eat should be, although the latter
is universally conceded to be a matter of prime importance.
The reason is that the poisons in the air, inspired by the
lungs, pass directly into the blood, whereas, taken into
the stomach, the action is much slower, and there is at
least the possibility of their passing through the digestive
tract unassimilated.

The olfactory nerves are the normal guides as to the
purity of the air, and, if they have not been dulled by
long usage in breathing impure air, they are extremely
sensitive to impurities in the atmosphere.

Country Air. — In the open air there is a constant, even
though insensible, movement of the currents of air;
the result is a constant renewal or ventilation of the air.
There is, in addition, the evaporation from brooks, rivers,
lakes, the dew and rain, which aid in cleansing the air
from dust ; the peculiar freshness of the air in the country
after a heavy fall of rain is familiar to all.

The " bouquet " of the air, most noticeable and delightful
in the early morning, especially in the spring of the year,
is due to the fragrance given off from the flowers, plants,
and trees, and imparts a feeling of exhilaration and a
sense of the joy of living.

Sunshine increases the respiratory movements.

Wind clears the air of impurities, and is only harmful
when it carries dust with it, or when it is so strong that it
impedes the respiration or bodily movements. Very
weak persons get out of breath easily when battling against
the wind.

Town Air. — Even the outdoor air of towns has its full
quota of oxygen,— 21 per cent.,— and so is healthier than
indoor air. The carbonic acid in the air varies from 0.2
to 0.6 per cent. Among the impurities of the air are
smoke, fog, and dust.

Dust and Its Relation to Disease. — Dust, consisting
of particles of all kinds of organic and inorganic matter,

150 PERSONAL HYGIENE FOR WOMEN

is a nuisance of indoor as well as outdoor life. That the
dust in cities is the intolerable nuisance and menace to
public health that it is, is due to the filthy condition of
the streets.

The specific cause of tuberculosis is the tubercle bacil-
lus. Considering the prevalence of the custom of spitting
on the pavements, streets, floors of public conveyances,
and public halls, that the dust from the streets is carried
into the houses on the shoes and the trailing skirts of
women, it is self-evident that anything which stirs up the
dust, as sweeping, stamping on the floor with the feet,
dancing, and on the streets strong currents of air and high
winds are a most serious menace to the health and lives
of the community.

In addition to the fact that dust is the great carrier of
the tubercle bacillus, the particles of dust cause a direct
irritation of the mucous membranes lining the nose, throat,
larynx, and bronchial tubes.

That dust is an important factor in the causation of
colds may be inferred from the facts that they are more
common in the city than in the country, and that hi the
city they are more frequent in the spring and fall, when
the streets are not watered.

The R61e Played by Bacteria. — Bacteria are distrib-
uted nearly everywhere and in larger quantities than is
generally believed. The air in open spaces in cities con-
tains from 100 to 1000 bacteria per cubic meter, while the
air of an inhabited room contains from 6000 to 10,000.

It can now be definitely stated that microorganisms
are the immediate or exciting cause of bronchitis observed
in diphtheria, in influenza, measles, . whooping-cough,
pneumonia, etc. These microorganisms are conveyed
both directly from the sick to the well, and from the inhala-
tions of the germs floating in the atmosphere. Whenever
dust is raised, we breathe in a great number of micro-
organisms.

In influenza the bacilli are found in the secretions of the
nose, throat, and in the expectorations from the Jungs.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 151

The bacilli are not only the cause of the acute infections,
but also of chronic bronchitis.

The bacterial flora usually present in the throat and the
respiratory passages is rich and varied. So long as the
mucous membrane lining these passages remains in a
healthy condition, an unfavorable condition is offered for
their growth and development and these microorganisms
are harmless. But just so soon as the general vitality
is lowered, or there is an impairment of the normal condi-
tion of the epithelium lining the respiratory tract, a cul-
ture-medium is provided in which these germs flourish
and grow. Anything which will cause an irritation or
congestion of the mucous membrane of the throat and
bronchial tubes furnishes the necessary conditions for the
infection to take place. The germs themselves excite an
acute inflammation, and the inflammation extends from
the head or throat to the bronchial tubes, through the
spread of the infective agent along the respiratory tract.

Ventilation. — Very few people in cities spend more
than one hour a day in the open air, which means that they
are housed up for the other twenty-three hours, so that
no pains should be spared to bring up the quality of the
indoor air to approximate as nearly as possible that of
the outdoor air. The air of houses contains many more
microbes than that of the street.

For dwelling-houses 3000 cubic feet of fresh air is needed
every hour. It is said that in the country the only bad
air is in farmers' houses, whence it has no chance to escape.

Direct sunlight kills the tubercle bacillus in thin layers
of sputum in five or six hours, and diffused sunlight in
several days, and proper ventilation greatly facilitates
this bactericidal action. A large cubic space is of little
avail if the ventilation is inadequate. The windows
should be at least one-seventh of the floor space.

The air of the house must be fresh, pure, and cool, to
allow proper ventilation of the lungs and skin. Colds
are prevalent in winter, because that is the season when
people are housed up and breathe impure air.

152 PERSONAL HYGIENE FOR WOMEN

The commonest causes of impurities of the air in houses
are the expired air and the transudation of the skin; the
production of the combustion of lights or unconsumed
gas may come from the burner when lit, if the pressure is
very strong, or the rubber fittings may retain the gas;
tobacco smoke; the effluvia of simple uncleanliness of
rooms and persons; and the products of the fluid or solid
excreta retained in the room. In addition, there may be
special conditions which allow the impure air to flow into
the room, as from the basement or cellar of a house, from
imperfectly trapped soil and waste-pipes, or from other
impurities outside of the house.

In respiration the air is vitiated by a decrease in the
amount of oxygen and an increase in the amount of car-
bonic acid ; the expired air contains about 4 or 5 per cent,
less oxygen and about that amount more of carbonic acid
than the inspired air. It has been estimated that an
individual takes into her lungs about 500 cubic inches of
air per minute and exhales the same amount of vitiated
air. The expired air is of a higher temperature, and is
loaded with aqueous vapor. The organic substances
present in expired air are in part the causes of the odor of
the breath; it is probable that many of them are of a poi-
sonous nature. The air is still further vitiated by the
products of decomposition of persons having decayed
teeth, nasal catarrh, and disorders of the digestive systems,
as well as by personal emanations.

When the sensibilities of the sense of smell become
dulled, they give no warning of the sense of danger, and
the individual may not feel conscious of the harm, al-
though the nervous centers may be greatly depressed,
and, because discomfort has not been experienced in a
vitiated atmosphere, it does not follow that harm has
not been done. The effects are slowly and imperceptibly
cumulative, but are on this account none the less injur-
ious, and are now recognized as being among the most
potent and wide-spread of all the predisposing causes of
disease. •

THE RESPIRATORY AND CIRCULATORY SYSTEMS 153

The physiologic effects of breathing vitiated air are that,
owing to the impurities of the air, the respirations become
quicker and shallower, the heart's action more rapid and
feeble; there is a more or less irritation of the mucous
membranes lining the nose, throat, and larynx. In
extreme cases, where many people are crowded together
and the ventilation is totally inadequate, the air often
becomes so impure as to cause headache, lassitude, nausea,
and fainting.

The long-continued action of such impurities on the
olfactory nerves may ultimately induce, through the cen-
tral nervous system, alterations in the respiration, circula-
tion, and nutrition. When moderately vitiated air is
breathed more or less continuously, the individual becomes
pale and loses her appetite; after a time there is a decline
in the muscular strength and animal spirits. The aera-
tion and nutrition of the blood is interfered with, and the
general tone of the system falls below par.

It has further been maintained that metabolism is
hindered by much-breathed atmosphere. In addition to
the ordinary symptoms of discomfort, the long occupancy
of so-called stuffy rooms so lowers the resistance as to be
conducive to the contraction of colds and even to more
serious infections.

People in this lowered condition of health, which is
very common among those who spend the greater part of
the day indoors, in offices, houses, schools, factories, and
workrooms, offer much less resistance to attacks of acute
diseases than do people who lead an outdoor life.

In considering the ventilation of a house, the purity of
the air, the temperature, and the dryness of the air must
all be considered.

The test now generally accepted as the standard of
purity of the air is not the chemical one of the estimation
of the amount of carbonic acid contained in the air of a
closed space, but that, on entering a room or closed space
from the outside fresh air, no sense of impurity or close-
ness should be noticable.

154 PERSONAL HYGIENE FOR WOMEN

The so-called natural ventilation of houses, which
takes place through the porosity of the walls, the cracks
around the doors and windows, is generally too inconsider-
able to be taken into account.

Where houses are heated by furnaces, a certain amount
of ventilation is furnished by this means, but the air is
by no means so pure as the air of a house heated by hot air
or steam pipes. In the latter case, the greatest drawback
is the dryness of the air.

As the air contained in an inhabited room cannot be
kept as pure as the outside air, the object of ventilation is,
by the admission of the pure external air, so to minimize
the impurities that the air respired may not be detrimental
to health.

The most effective means for the ventilation of houses
and apartments is the throwing wide open all doors and
windows; the windows must be opened at both top and
bottom, as the hot impure air rises and the cold air falls
to the floor. The length of time which the house should
be left open will depend on the outside temperature and
the velocity of the winds. This ventilation of the entire
house should be carried out three tunes a day — in the
early morning, at noon, and again in the evening. -

In addition to this, provision should be made for a con-
stant access of fresh air to the room. A simple and
rather primitive method is by raising the lower sash by
a strip of wood several inches in height and the exact
width of the window. The air will then enter the space
between the upper and lower sashes. Some such or
any better method of ventilation should be in continuous
use, day and night, when the room is occupied. So soon
as the weather is sufficiently mild, some of the windows
should be left open all the time.

When the air of a room is fresh and pure, the human
system is furnished with all the oxygen it can consume,
and heat is thus introduced into the body, so that a
lower external temperature is necessary for comfort.
Hence, supplying a sufficient quantity of fresh air mini-

THE RESPIRATORY AND CIRCULATORY SYSTEMS 155

mizes the amount of coal consumed, besides increasing the
vigor of the body.

The temperature of the house will depend on the occupa-
tion, age, and health of the inhabitants. With a sedentary
occupation, a temperature of from 64° to 70° F. is the
most suitable. The temperature of the bedroom at
night should not be allowed to fall below 50° F. Every
room in the house should be furnished with a thermometer.

The Injurious Effects of Overheated Air. — A rise
of temperature in the surrounding air diminishes the
amount of oxygen consumed and the amount of carbon
dioxid discharged; a fall of temperature has the opposite
effect. In addition, this overheated air forms a hot
jacket about the body, which prevents the radiation of
heat necessary to keep the body in a healthy condition.

For the same reason, when out-of-doors, furs should
not be worn close up around the neck, and fur coats
should only be worn in the extremely cold weather.
Paper and rubber worn about the body act in the same
way, by preventing the radiation of heat and moisture —
practically steam jackets are formed; the skin is rendered
very sensitive and susceptible of chilling on the slightest
fall of temperature.

The Proper Degree of Moisture of the Air of the
House. — The air below the freezing-point is deprived
of much of its moisture; brought into the house, and
raised from 70° to 80° F., or drawn into the nostrils and
raised to 98° F., it must take up its quota of moisture.
This moisture must, therefore, be provided in the air of
the house. In the case of houses heated by furnaces,
some moisture is furnished by the water-pans of the
furnace; but in the case of heating by hot air and steam
pipes, there is less circulation of air, the air is very much
drier, and generally of a very much higher temperature.
A satisfactory method of furnishing these houses with
the proper degree of moisture has not yet been invented.

One is only comfortable in a dry air when it is of a low
temperature. When the dry air becomes heated, there is

156 PERSONAL HYGIENE FOR WOMEN

more moisture given off by the mucous membranes,
which causes a feeling of dryness and irritation in the
nose, throat, and larynx; there may also be a sensation
of uneasiness of the chest, and, at the same time, the
individual feels chilly.

Persons constantly breathing abnormally dry air lower
the resisting power of the respiratory mucous membranes
and become very susceptible of taking cold.

Since the degree of moisture of the air of a house is
equally important as its temperature, every room should
be furnished with a hygrometer, which should register
from 65 to 70 per cent, of moisture.

The Ventilation of Bed-rooms. — The importance
of the proper ventilation of the sleeping-room will be
seen from the fact that two-thirds of the oxygen absorbed
in the twenty-four hours is absorbed between 6 o'clock
in the evening and 6 o'clock in the morning; and on
the state of the air of the bed-room will depend greatly
the vitality of the individual. During sleep inspiration
occupies ten-twelfths of the respiratory period, while at
other times it occupies only five-twelfths of that period.
In a closed room the oxygen would eventually be con-
sumed, the air become filled with impurities, and the body
languish for want of oxygen and incapacity to throw off
its impurities.

The air of the room should be perfectly fresh on retiring;
where it has been used as a sitting-room, it should be
thrown wide open and thoroughly ventilated just before
going to bed. The temperature of the room should not
be above 65° F. In the bed-room at night all the air
coming into the room should come from the same side
of the room, and the doors opposite should be closed.
If the room is small, and the window is at the head or
foot of the bed, some provision must be made to screen the
bed, and to allow the air to enter the room without
falling directly on the sleeper.

In the intense heat of summer, especially if the air is
saturated with moisture, one sleeps much ntore com-

THE RESPIRATORY AND CIRCULATORY SYSTEMS 157

fortably on the side, with the face almost at the edge of
the bed; in this way the formation of a stagnant pool
of exhaled air about the face is prevented, which would
otherwise be rebreathed, and greatly increase the feeling
of discomfort and malaise.

On retiring at night the clothes worn during the day
should be spread out over chairs to become thoroughly
ventilated, instead of being hung up in a closed press or
closet. From a sanitary point of view, it is essential
that every article of clothing worn during the day should
be removed at night. Both clothes and body need venti-
lation.

In the morning the clothes should all be taken off the
bed, and they, as well as the night-clothes, should be
spread out to be aired during the ventilation of the room.
The windows are thrown wide open when one goes to
breakfast.

The Care of the Nose, Throat, and Ears. — It will be
most profitable to consider the care of the nose, throat,
and ears together, since the mucous membrane lining
these cavities is continuous, and so there is always great
danger of an inflammation of one extending to the others.

It has been calculated that about one-third of our adult
population are notably deaf in one or both ears. In the
majority of cases deafness is the result of colds and
throat troubles, and much can be done to prevent its
occurrence.

The nose communicates through the nasal fossae with
the nasopharynx, and the mucous membrane lining the
nose is continuous with that lining the throat.

The nose performs four important functions — it serves
as a passageway for the air in breathing, and it warms,
moistens, and filters the inspired air; it is the organ of
smell; it aids in phonation; and it affords ventilation
to the ears and accessory sinuses. But by far its most
important function is the role which the nose plays in
respiration. To supply the large amount of water neces-
sary to moisten the inspired air, it has been calculated

158 PERSONAL HYGIENE FOR WOMEN

that about one pint of water must be secreted by the
nose daily; part of this amount of moisture is furnished
by the tears. Mouth-breathing always causes dryness
of the throat.

The filtration of the air is accomplished first through
the action of the hairs at the external margin of the nose,
which hinder the entrance of large particles, and, second,
by the adherence of small particles to the moist surface
of the intricate passages of the nose and nasopharynx.
The microbes are expelled with the dust; in addition to
this, the nose probably has the power of destroying any
bacteria through the action of its germicidal mucus.

Obstruction of the Nasal Passages. — In adults the com-
monest modes of obstruction are the bending of the nasal
septum to one side, or by a thickening of the septum
by which one nostril may be completely closed up. The
occlusion may also be due to the swelling of the mucous
membrane or the presence of polypi.

In children the most common form of obstruction of
the nose is by the adenoids and the enlargement of the
tonsils; this enlargement may be so great as to prevent
nasal breathing and interfere with the normal ventilation
of the ears.

The Throat or Pharynx. — The throat or pharynx is the
upper and funnel-like portion of the alimentary canal,
which is seen at the back part of the mouth. It extends
up back of the nose. The cavity of the throat is some-
what separated from that of the mouth by the soft palate.
This is a membranous curtain, which is attached to the
posterior part of the hard palate. The pendulous part
of the soft palate is known as the uvula. The uvula
sometimes becomes so greatly relaxed that it rests on the
base of the tongue, which causes a constant irritation
and slight cough, a condition which is easily relieved by
a few astringent applications.

On looking into a mirror there will be seen, on either
side of the throat, two arches, formed by folds of mucous
membrane; these are known as the pillars of the throat.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 159

Between these pillars, on either side, is an almond-shaped
body called the tonsil. In health the tonsil should not
protrude beyond the anterior pillar.

Causes of Diseases of the Nose and Throat. — Exposure
to wet and cold, when insufficiently clad, or, even worse,
sitting still with damp skirts or shoes on. A still more
potent factor than exposure to cold is the relative degree
of humidity of the atmosphere; great humidity is fre-
quently accompanied by epidemics of influenza. Ex-
posure to very high winds; sudden changes of tempera-
ture; the very dry air and the overheating of houses;
insufficient covering at night; the inhalation of irritating
vapors and finely divided mechanical irritants. Also,
gastro-intestinal affections and uric acid.

Chronic enlargement of the tonsils predisposes to
tonsillitis and to all the infective and contagious throat
diseases. In addition, the breath is apt to be fetid, and
swallowing the mucus, germs, and toxins has a deleterious
effect on the stomach and general health. Mouth-breath-
ing and anemia often follow, and there is an increased
liability to inflammation of the eyes.

The Importance of a Healthy Condition of the Throat
and Nose. — The nose and throat are the portals of entrance
to the bronchial tubes and lungs, and it depends on the
condition of their mucous membranes whether the germs
of disease will find lodgment here and be carried down
into the bronchial tubes and lungs, or whether they will
be expelled with the mucus.

Any irritant which destroys the vitality of the epi-
thelium covering the mucosa, or a local congestion which
interferes with the nutrition, circulation, and secretions
of the part, offers favorable conditions for the culture of
bacteria normally present. Also, anything which will
cause a lowering of the general health, and thereby
lessen tissue resistance, acts as a predisposing cause to
local inflammation, while the germs themselves excite
inflammation by their active growth in loco.

From these facts will also be seen the importance of

160 PERSONAL HYGIENE FOR WOMEN

having cut short, as rapidly as possible, any congestion or
inflammatory troubles of the nose and throat.

Prevention of Nasal Catarrh and Sore Throat. — First in
importance comes attention to the general health. Under
this must be considered the clothing, food, ventilation,
and exercise.

The clothing should be light, yet sufficiently warm to
be a protection against the cold and winds. Heavy shoes
with thick soles are necessary to protect the feet, and it
is not so much the matter of getting wet as it is of sitting
down with damp clothing on.

An atmosphere filled with dust in sweeping should not
be tolerated in any well-kept house.

Local Treatment for the Prevention and Cure of Mild
Cases of Nasal Catarrh and Sore Throat. — The treatment
is practically the same. The toilet of the nose and throat
should be made at least as often, and at the same time,
as that of the teeth; certainly, the first thing on getting
up in the morning and again before dressing for dinner.
In our seaboard cities and towns, at least, there is a very
general predisposition to some degree of congestion of
the mucous membrane of the nose and throat. This means
an abnormal amount of mucus which collects in the parts
during sleep. Again, on coming in from out-of-doors
on a windy day a large amount of dust, which means
microbes as well, has become lodged in the mucous mem-
branes of the nose and throat.

This toilet of the nose and throat is best carried out
by means of a nasal spray. The spray apparatus consists
of a bottle holding some two ounces, a hard-rubber
spray piece, and a bulb with tubing to force the liquid
through the spray piece. The tip of the spray should
have the form of a cone; this should be introduced into
each nostril, the bulb squeezed several times, until the
amount of fluid is sufficient to be hawked out, and this
process is facilitated by holding the mouth open during
the spraying of the nostrils. After the nostrils have been
thoroughly cleansed, the throat should be sprayed directly.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 161

The liquids used must be bland and unirritating, and
only enough should be used at one time to cleanse the
parts. There are on the market excellent alkaline and
antiseptic tablets; one tablet should be dissolved in a
spray-bottle not quite full of water. This solution keeps in
perfect condition, and is always ready for use.

A solution of boric acid, in the proportion of two tea-
spoonfuls of boric acid to one pint of water, may also be
used.

If the nose and throat are inflamed, this so-called water
spray should be followed by an oil spray, which will be
found to be most soothing and healing. A separate
apparatus for this will be necessary, as an oily solution
would clog an ordinary water-spray, but the principle
of the spray is the same, and it is used in the same way.
The following is an excellent formula: Take of menthol
and carbolic acid each two grains; of eucalyptol, six drops;
and of albolene, two ounces. Mix well, and fill the spray-
bottle one-third full; it is to be used in the full strength.
Use only enough of this spray to moisten the nose and
throat; by inhaling simultaneously with squeezing the
bulb, the very fine spray is carried into the larynx, and
so is very useful when there is an irritation of that organ,
as shown by hoarseness. If there is only a slight irrita-
tion of the parts, the use of the spray twice daily will be
sufficient; the last time should be just before retiring.
On windy days it will be a great protection to the mucous
membrane of the throat to use it just before going out-
of-doors, on the throat only. If the inflammation is severe,
the spray may be used as often as every two hours. This
prescription should be put up by a good druggist.

Ear specialists condemn all nasal douches as dangerous,
on account of the possibility of the water being forced into
the Eustachian tubes.

General Treatment. — First of all, the system must be

toned up by the systematic use of cold baths, adapted

to each particular case, tonics, iron, and cod-liver oil.

It is a grave mistake to allow these cases to become

11

162 PERSONAL HYGIENE FOR WOMEN

chronic, as they may be the forerunners of influenza
and even general tuberculosis. They need prompt and
scientific treatment, which the physician alone is capable
of giving.

The Ear. — The ear is divided into three parts — the
external ear, the middle ear or tympanum, and the internal
ear or labyrinth. The internal ear is the essential part
of the organ of hearing in which the auditory nerve ends.
Its structure is very complicated. The external ear is
separated from the middle ear by the tympanic mem-
brane or drumhead. This is a thin, small, membranous
sheet, which is stretched tautly across the junction of
these two cavities, and vibrates inward and outward
between them. The external ear collects and conducts
the waves of sound to the tympanum.

The middle ear, or tympanum, is an irregular cavity,
situated within the bone. It is traversed by a chain of
movable bones, which connect the drumhead with the
internal ear, and serves to convey vibrations of sound to
it. The middle ear, or drum cavity, is filled with air,
and communicates with the pharynx by means of the
Eustachian tube. The middle ear is lined throughout
with mucous membrane, which is continuous with that of
the throat and nose.

The Eustachian tube is continuous with the middle
ear, and extends downward and forward about an inch
to connect it with the pharynx, where it opens by a
trumpet-like expansion, just above the soft palate, at the
junction of the throat and nose. It serves to carry off the
excess of fluid from the middle ear and to preserve the
equilibrium of the pressure between the gaseous contents
of this cavity and the atmosphere. The walls of the
Eustachian tube are in close contact, but they are
normally opened during every act of swallowing, yawning,
etc., when the air finds its way into the middle ear. A
stoppage of the nose reverses the process, and when the
tubes are not likewise stopped up, every swallowing
motion draws air out of the tubes. If the openings of the

THE RESPIRATORY AND CIRCULATORY SYSTEMS 163

tubes become closed, deafness, dizziness, and subjective
noises will result.

The middle ear is the seat of about two-thirds of all
aural troubles, and, since much of this could be prevented,
this becomes a matter of great practical importance.

Causes of Impairment of Hearing. — The majority of the
affections of the middle ear originate from extensions of
catarrhal inflammations, from the nose and throat, through
the Eustachian tubes. In children adenoids are the most
frequent cause of deafness. The so-called hereditary
deafness is probably due to an inherited configuration
of the septum of the nose, a bending of the septum to one
side, or a tendency to catarrhal affections of its mucous
membranes.

Every cold in the head tends to mechanically involve
the ears, and, while recovery may seem complete, there
is likely to be some unrelieved trouble which insidiously
but steadily increases — first one ear, and then the other,
shows signs of defective hearing. If only one ear is in-
volved, the condition may progress seriously before the
patient is aware of the trouble.

Preventive Measures Against Deafness. — From what has
been said, it naturally follows that the preventive measures
must be chiefly those already given against taking cold.
If one does take cold, instead of leaving it to run its
course, as is too often done, proper therapeutic measures
should be at once adopted to bring as speedy a cure as
possible.

Impacted Ear-wax and its Removal. — A healthy ear
should never show more than enough wax to render the
hairs within soft, and the individual should be uncon-
scious of the wax coming away. Wax does not collect
in a healthy ear. When it does occur, there is a stopped-
up feeling in the ears, due to the occlusion of the meatus
by wax.

The only procedure that is safe to follow in order to
remove the wax from the ear is to gently douche the ear
with warm water, at a temperature from 105° to 110° F.

164 PERSONAL HYGIENE FOR WOMEN

If this does not suffice, a physician must be consulted, as
all efforts to remove the wax after it has become impacted
are dangerous and futile except in skilled hands.

Earache. — The best tiling for the relief of earache is
the external application of heat by means of a hot-water
bag. If this does not give relief, the ear may be douched
with warm water. Earache can often be prevented, by
those subject to it, by placing a very small piece of
absorbent cotton in the ear before going out in very high
winds or in automobiling.

Impediments to Normal Respiration. — These are, for
the most part, acquired through improper habits of posture,
dress, lack of muscular and chest development. Other
impediments to respiration are a deviation of the septum
of the nose to one side, marked curvature of the spine,
and deformities of the chest which may be the results of
rickets.

Curvature of the spine is frequently the result of mus-
cular weakness, combined with faulty position at the desk.

The clothing must be sufficiently loose to admit of the
fullest possible chest expansion; the measurements for
the clothing, and most especially for corsets, must be
taken during full chest expansion.

Heavy clothing suspended from the shoulders is also
hurtful, because it renders impossible the expansion of
the apices of the lungs. Obviously, all tight bands around
the neck interfere with the respiratory movements.

Bodily position plays a very important part in main-
taining the symmetric development of the chest and
in the proper ventilation of the lungs; and this is a matter
of the greatest importance to students, clerks, and writers
who spend a great part of every day at the desk.

The faulty attitude, together with the weak muscles
and the poor muscular development, are fruitful sources
of spinal curvatures and flat chests; and free respiration
is interfered with. Writing with a pen is most apt to be
accompanied by a peculiarly cramped position of the
body, rendering normal respiration impossible.

THE RESPIRATORY AND CIRCULATORY SYSTEMS 165

The Correct Attitude at the Desk. — The chair should be
of such a height that the woman may rest her feet firmly
and easily on the floor or upon a foot-rest, the seat being
deep enough from before backward to accommodate about
three-fourths of the length of the thiglis, while the back
of the chair should be so curved as to support the spine
easily hi its natural curves, both at the waist and at the
level of the shoulder-blades.

The chair and desk should be sufficiently close together
so that the student may sit erect to read from books,
since leaning forward at the desk causes round shoulders,
flat chest, and short-sightedness. When the desk and
chair are properly arranged, two-thirds of the forearm
can be rested upon the desk without raising the shoulders.

In reading, the distance of the book from the eyes should
be twelve inches, and the book-rest should be inclined,
sloping downward toward the reader, at about an angle
of 85 degrees.

If the woman has any great amount of writing to do,
she should learn to use a typewriter. In using this
machine she not only writes very much more rapidly
and easily, but the position of the body is much more
erect than that assumed when using the pen, and it is
not nearly so fatiguing to the muscles of the hands and
arms.

All closely confining sedentary occupations, as writing,
sewing, etc., should be frequently interrupted to move
about for a few minutes, rest the eyes, and take a few
deep breathing exercises before an open window; this
is necessary for the eyes as well as for the ventilation of
the lungs.

Ventilation of the Lungs and Breathing Exercises.
— Forced respiration is essential to completely change
the air in the lungs, to maintain the elasticity of the lung
tissue, and to expand the chest in every direction. Only
in this way can a thorough ventilation of the lungs take
place; a full supply of oxygen is taken in, which stirs
up, disinfects, and cools the stagnant residual air, and

166 PERSONAL HYGIENE FOR WOMEN

forced expiration expels the respiratory excretions. One
of the frequent causes of foul breath is lack of ventila-
tion of the lungs, so that the expired air becomes laden
with impurities.

In normal breathing the current of air which passes in
and out of the lungs travels through the nose, not the
mouth. The ingoing air, by exposure to the vascular
mucous membrane of the narrow and winding nasal
passages, is warmed and moistened, and at the same time
the mouth is protected from the desiccating effects of the
continual inroad of comparatively dry air.

By means of respiratory exercises the mobility of the
chest may be greatly augmented; there is an increased
flexibility of the ribs and sternum, as well as loosening
of the thoracic joints, which may have become stiff, and
these exercises also lead to a development of the respiratory
muscles.

In this manner only can the frame work of the chest
become thoroughly inflated from within, and thus all
parts of the lungs, which run the risk of becoming in-
capacitated from lack of use, be brought into play.

It is highly important that this thorough ventila-
tion of the lungs should take place at least three times
a day — the first thing in the morning, while making the
toilet, again about the middle of the day, and at night
just before retiring.

To obtain the greatest benefit from these exercises
they must be taken without corsets, the clothing must be
light and loose, and the body lightly clad. The air in
the room must be fresh, and after they have been learned,
they can, as a rule, be taken before an open window. In
the morning they are best taken just after the cold bath,
when, by removing the impurities and filling the lungs
with fresh air, and at the same time starting up a good
vigorous circulation, they cause one to begin the day
with energy and zest.

The respiratory movements are diminished during
sleep, and at the same time there is a large accumulation

THE RESPIRATORY AND CIRCULATORY SYSTEMS 167

of blood in the splanchnic veins, so that, particularly
when there is any tendency to difficulty with the breathing
at night, the trouble is greatly lessened by filling the lungs
with pure air just before retiring.

It is necessary, first of all, to learn the art of breathing,
to be able to dissociate the clavicular, the costal, and the
diaphragmatic. By clavicular breathing is meant the
raising of the collar-bone and shoulders as high as possible
by means of a slow but deep inspiration — this expands the
apices of the lungs; costal breathing is the throwing out
arid expanding the chest to its utmost capacity, and so
enlarging the chest in its transverse and anteroposterior
diameters; diaphragmatic breathing is the depression of
the diaphragm and the protrusion of the abdomen with-
out raising the lower ribs. The last is the most readily
learned in the supine position ; the bed supports the weight
of the body, so that the individual is able to concentrate
her entire attention on fixing the bony thorax, depressing
the diaphragm, and protruding the abdomen at every in-
spiration and retracting it to the utmost with every ex-
piration. This, of course, develops and gives tone to the
abdominal muscles.

When the woman has conquered these first principles
of respiration, she is ready to put them into practice
in the standing posture. They should be learned before
a mirror, and after that taken before an open window.
The hands should be placed on the hips; first elevating
the collar-bones and the shoulders to the utmost, while
still holding the breath, she expands the chest, always
breathing in from above downward, and, lastly, the
diaphragm is depressed. With the lungs thus expanded
to their utmost capacity, the breath is held as long as
possible, then the lungs are emptied by an abrupt and
forced expiration.

These exercises should be repeated at first ten times,
gradually increasing to thirty times. It is well to take
one or two ordinary respirations between the forced
ones.

168 PERSONAL HYGIENE FOR WOMEN

It will be found that, as these exercises proceed and
the lungs are filled with purer air, the breath can be held
for a longer period of time, and that with practice the
length of time that the breath can be held is greatly
increased; it should be held for half a minute. Public
speakers, singers, and divers are all skilful in this respect.

When these simple breathing exercises have been
mastered, breathing exercises can be combined with
other exercises, which have as their aim the development
of the muscles of the chest.

Reading aloud, singing, talking, laughing, are all good
exercises for developing the capacity of the lungs.

The Cure of Chronic Bronchitis by Deep-breathing
Exercises. — The upper part of the body must be nude
and the exercises taken before a mirror, so that the
woman can watch the movements of the chest and
abdomen, see that all the hollows of the chest are filled
out during forced inspiration, and that the muscles of
the abdomen are properly retracted. For the average
woman this last will be the most difficult; in beginning
these exercises she will find that it will require all her
concentrated energy and will power to cause a retraction
of these disused muscles.

Patients with chronic bronchitis do not have the
ability to perform forced respiration properly. The
respirations are too superficial, and the respiratory move-
ments are not properly performed.

As respiration is ordinarily performed, the partial
expansion of the upper part of the chest is accompanied
by a contraction of the abdominal muscles, whereby the
diaphragm is forced upward, with the result that the
lower part of the lungs remains very slightly expanded,
whereby the circulation as well as the removal of mucus
is imperfectly performed. This lack of forced respiration
is a frequent cause of acute bronchitis running into a
chronic form.

In chronic bronchitis it is especially in the lower part
of the lungs that stagnation of the secretions takes place,

THE RESPIRATORY AND CIRCULATORY SYSTEMS 169

and they can only be dislodged from the mucous mem-
brane by forced abdominal expiration and the ascent of
the diaphragm. This causes a cough which expels the
mucus, and forcible abdominal expiration and cough
are the only means of drainage of the lower and deep-
seated parts of the lungs. Further, in forced respiration
the muscle tissue of the bronchial tubes contracts, which
certainly does not take place in ordinary respiration, but,
on the contrary, this tissue atrophies.

Other beneficial results from forced respiration are
increased oxygenation, improved nutrition, changes of a
mechanical nature, ventilation, and disinfection of the
lungs, massage of the lungs and pleura, and drainage.

No other method of treatment is so successful in the
cure of chronic bronchitis not dependent on disease
of the nose and throat. In from two to six weeks of treat-
ment, in which there is a profuse discharge of mucus,
it will be found that the bronchial tubes have cleared up,
provided that the patient is supplied with an abundant
supply of fresh air day and night. Methodically practised,
deep breathing is not only the surest cure, but also the
safest stimulating expectorant.

Relation of Colds and Influenza to Pneumonia and
Tuberculosis and their Prevention. — We have already
seen that bacilli are not only the cause of acute infec-
tions, but also of chronic bronchitis, and that this was
especially true of the bacillus of influenza and the pneu-
mococcus of pneumonia.

It is well known that influenza is an infectious disease,
which rapidly spreads through the family and the com-
munity, but it is not so well known that the so-called
"common colds," ordinary sore throat, and tonsillitis
are also highly contagious. The infection is carried from
one person to another by direct contagion; the air is
being constantly sprayed with the germs of disease in
talking, laughing, sneezing, and coughing. In coughing
and sneezing it is not sufficient to hold the hand before
the mouth — a handkerchief must be used for this purpose.

170 PERSONAL HYGIENE FOR WOMEN

Colds are among the most frequent of the so-called
minor ailments in this country. The causes are the over-
heating of the houses, the great dryness of the air, badly
ventilated houses and public assembly rooms, which
render people very susceptible to the great variations in
temperature.

Prophylaxis, or the prevention of colds, combine all those
measures which promote the general tone of the system,
and may be said to embrace all the elements of personal
hygiene. Good digestion and proper nourishment of
the body with suitable food; the proper ventilation of
houses, ah1 public buildings and conveyances, for in these
latter the public are brought into very close contact with
their fellow-men.

Local prophylaxis would consist in the toilet of the
nose and throat — the removing of adenoids and enlarged
tonsils.

The individual must remember that she can reinfect
herself; for this reason, an abundant supply of hand-
kerchiefs must be used; they should be placed in a
handkerchief bag and washed separately. Packs of cards
should be thrown away before they become soiled. Sprays
and atomizers must be individual property, and be kept
thoroughly cleansed.

With the exception of deep-seated chest colds, in the
early stages a cold may often be nipped in the bud by a
few hours of hard sudorific work in the open air. In half
a day the nasal ducts and respiratory system will throw
off irritating matter that would take much longer time
if the patient remained indoors and relied on the action
of drugs alone.

Treatment. — Other methods of treatment are a hot
tub-bath on retiring, an active but not too severe cathartic,
as two grains of calomel, taken just before going to bed,
and, if the individual is chilly, a hot lemonade should be
taken at the same time. Both the cathartic and the
free perspiration will aid in relieving the internal con-
gestion and thus aid in its abortion. A cold, sponge

THE RESPIRATORY AND CIRCULATORY SYSTEMS 171

should be taken the following morning to tone up the
system. Turkish baths are also useful in breaking up
colds; again, the precaution must be taken to avoid chill-
ing on leaving the bath.

The following tablet is a very simple and very efficacious
remedy for breaking up a cold in the early stages: Take
of powdered camphor i gr.; of the sulphate of quinin
J gr. ; and of the fluidextract of belladonna root i minim.
This should be well mixed, and made up into one tablet,
or ;i capsule. One tablet is taken every half-hour, until
four doses have been taken; after that one tablet every
three hours, until the running of the nose has ceased,
which generally occurs within twenty-four hours. If
there is not marked improvement at the end of this time,
or if there is any fever, a physician should be consulted
at once.

Quinin, when given alone to abort colds, must be given
in sufficiently large doses to produce cinchonism, the
subjective symptom of which is a slight deafness or
ringing of the ears. The natural tendency of cold is to
cause inflammation of the middle ear, and since the use
of quinin in large doses causes a congestion, and so pre-
disposes to inflammation of the middle ear, its use should
be avoided.

The great amount of illness and mortality from pneu-
monia during and following epidemics of influenza is
too familiar to the public to need more than mentioning.
The patient is so rapidly and extremely prostrated by
the attack of influenza as to be susceptible to the ready
action of the pneumococcus, which, as we have seen, is
ever present, and the extension of the inflammation
from the fine bronchial tubes to the air-cells of the lungs
rapidly takes place. In the exhausted condition of the
patient she is not able to resist this invasion, the heart
is already weakened, and death frequently rapidly ensues
as the immediate result of heart failure.

The Prevention of Tuberculosis. — The tubercle
bacillus is practically ubiquitous, and the prevalence of

172 PERSONAL HYGIENE FOR WOMEN

tuberculosis is universal. Hence it is imperative to
raise the resistance of the individual in every way pos-
sible, as well as to limit the spread of the infection. This
means the employment of all the resources of public and
personal hygiene, public and private sanitation, and the
education of the public in how the disease is disseminated,
and how its spread may be prevented; also the teaching
of the individual, her duty to the family and society, as
well as to herself, in order not to spread the contagion.

Tuberculosis attacks the crippled and poorly developed
lung just as surely as it shuns the one which is fully ex-
panded and in constant and active service. Numerous
observations have established the existence of a constant
ratio between tuberculosis of the lungs and deficient
chest expansion.

Diet. — The doctrine has been growing among the laity
that the child's likes and dislikes should determine what
food it should eat. Thus a finical taste is cultivated
and a lack of proper nourishment follows, and it is this
finical diet class of people which forms a large percentage
of tuberculous invalids. It has long been recognized
that a proper diet and the tolerance of it is of the utmost
importance in the treatment of tuberculous patients,
but from the foregoing it would appear that a proper
diet throughout life is also of the utmost importance
in the prevention of disease; a sufficiency, not only as to
quantity, but also as regards variety.

It is the patient who can eat everything who stands a
good chance of getting well. So, too, it is the individual
whose diet for years has been perverse, who could not
eat meat, to whom eggs were distasteful, who could not
stand milk, who was infected with the vegetarian fad,
or the two-meal-a-day fad, who stands a fair chance of
falling a victim to tuberculosis, through a lowered tone
of the system, because it offers but a feeble resistance
to a powerful and insidious enemy. And the mode of the
preparation of the food is an equally important factor.
It has been shown that the poor cooking among ihe lower

THE RESPIRATORY AND CIRCULATORY SYSTEMS 173

classes is a powerful predisposing cause to intemperance
and tuberculosis.

Influenza is a frequent and important agent in bringing
to light latent tuberculosis, and must be classed as an
important exciting if not predisposing cause. Low,
damp climates predispose to the infection by lowering
the vitality. Tuberculosis is more prevalent in cities
than in rural communities, due to the manner of housing
and the character of the occupation.

Summary of the Present Views of Infection. — The doctrine
of inherited and acquired susceptibility still holds sway;
next, that all infants are susceptible, and that suscepti-
bility lessens with increase in age; that adults are com-
paratively insusceptible when free from geiieial and local
lowered resistance and repeated and prolonged exposure.

As to the source of infection, the consensus of opinion
and ascertained facts point to the sputum as of over-
whelming importance; cow's milk is an important factor;
the food may be infected directly by coughing, or the
dirt and dust from the floor and hands; the fingers and
many other objects that find their way into the child's
mouth are sources of danger. To adults, both dust and
moist droplets are more often the source of infection than
infected food.

Expectoration. — Careless expectoration is the chief
source of infection. Laws should be passed and enforced
prohibiting the expectoration on pavements, stairways,
in all public conveyances, and all public places.

The danger of infection from tuberculous house servants
has not been sufficiently appreciated. A chronic cough
in the case of a servant should be at once investigated
by the family physician. Servants should be taught
the necessity for washing the hands before touching the
food or cooking utensils. The condition of their rooms,
clothing, bathing, and other personal habits should be
closely investigated, and personal cleanliness should be
demanded as a sine qua non for obtaining or keeping a
situation.

174 PERSONAL HYGIENE FOR WOMEN

Since it is a well-known fact that tuberculosis can be
acquired from the occupation of houses and rooms
formerly occupied by tuberculosis patients, it has been
suggested that a clean bill of health should be demanded
of the owner of the house before renting it; that is,
a certificate from the Board of Health, that no case of
infection has existed in the house, or that it has been
properly disinfected since that time. If such a move-
ment became popular, landlords would be obliged to
furnish these bills of health in self-defense. Since the
Boards of Health demand the reporting of all cases of
tuberculosis, this scheme is by no means impracticable or
Utopian.

The tubercle bacillus is not destroyed by any degree
of cold, but both light and sunlight are distinctly injurious
to these bacteria. The lowest fatal temperature to the
tubercle bacillus is 131° F. of moist heat, acting for a
period of six hours. The thermal death-point of tubercle
bacilli in milk is of great practical importance, and many
experiments have been made which have determined that
a temperature of from 140° to 167° F., was sufficient if
continued for one hour. If it is desired to pasteurize the
milk, it should be placed in a closed bottle or stirred and
heated for at least twenty minutes at a temperature of
149° F.

Disinfection. — The use of formaldehyd gas has practi-
cally displaced the use of sulphur for the fumigation of
rooms, as well as for the disinfection of furniture and
clothing. For this purpose a moist vapor used in a sealed
room is essential.

At least 8 ounces of the commercial 40 per cent, formalin
should be used for each 1000 cubic feet of air content.
The most efficient method is that used by Biggs, of New
York, which is as follows: For an ordinary room, 1000
cubic feet, 1 pound of lime, 8 fluidounces of formalin, and
from 2J to 3 fluidounces of commercial sulphuric acid
are required. All openings but the door are sealed. The
formalin is poured into an empty water-pitcher, 4 ounces

THE RESPIRATORY AND CIRCULATORY SYSTEMS 175

of water are added, and then the sulphuric acid is poured
slowly in. The lime is placed in a china or earthenware
wash-basin on the floor upon newspapers; all water is
removed from the room. All drawers and cupboards
opened; the mattresses stood on end; and the mixture
poured quickly upon the lime, when the door is sealed.
The sulphuric acid may be packed in a tin bucket contain-
ing the lime, and, with the formalin in a separate bottle,
may be used by any person of ordinary intelligence.
The room should remain closed from twelve to eighteen
hours. It must not be lost sight of that after disinfection
by means of formalin a thorough cleansing is imperative.
A room which has been thoroughly cleaned and carbolized
is safer than a room which has been disinfected with
formalin and not properly cleaned.

After death or removal the entire place should be
renovated. Besides disinfection and scrubbing the
painted woodwork with a solution of hot soda water,
the walls should be repainted or repapered, and the wood-
word repainted.

Rugs, bedding, pillows, and clothing should be disin-
fected by hanging up in the room while it is undergoing
disinfection. Books and all articles of small value should
be burned. All soiled linen should be boiled.

The Kidneys and their Function. — The kidneys are
the secretory organs of the urine; they are two in number,
and are the largest tubular glands in the body. They
are deeply seated in the lumbar region, lying one on each
side of the vertebral column; the kidneys extend from
the eleventh rib nearly to the crest of the pelvis. They
are usually embedded in a considerable quantity of fat,
which is the chief factor in holding them in position,
aided to some extent by the large blood-vessels with
which they are connected. The kidneys are oblong
bodies and measure about 4 inches in length, 2J inches
in breadth, and over 1 inch in thickness. Their weight
is about 4} ounces.

Aa an excretory organ the kidney probably stands

176 PERSONAL HYGIENE FOR WOMEN

second to the alimentary canal; it surpasses in importance
the skin, whose total excretion of water it equals. The
abnormal substances appearing in the urine are often
not the products of disease of the kidneys, but of some other
organ or system.

The kidneys excrete and put the finishing touches
upon the urinary fluid; they act at the end of the meta-
bolic course, both as active and as passive agents. While
to some extent the kidneys are mechanical contrivances,
mere filters, so to speak, they are to a far greater degree
active, specific glands. The renal epithelium has the
power of synthesis, and builds up complex substances
that are not apparent as such in the blood or lymph, as
well as the power of analysis or breaking down of sub-
stances. These changes are due to the formation in
the tubular cell of an enzyme, which we call histozyme.
The kidney is the end link in the vascular chain, and the
daily performance of healthy kidneys is no doubt a
combination of the mechanical and the vital processes.

The Secretion of the Urine. — In a perfectly normal being
the problems of waste and repair are balanced to a nicety.
As we know, the tissues of the body are bathed in lymph
containing in solution the compounds that are necessary
for their nourishment — proteids, carbohydrates, fats,
salts, and gases. Waste follows in direct proportion to
the activity of the tissues. The worn-out, effete material
first finds its way into the lymph, and from it into the
blood-stream, to be later eliminated from the economy,
else deleterious results will follow their retention in the
body. It is by the selective action of the cells of the
various glands of the body that these useless substances
are removed from the blood, and converted into such
forms as can be readily excreted. In the main, the
products to be removed are urea and the allied nitrogenous
bodies — carbon dioxid, salts, and water. These organs
are of vital importance, since nearly all of the waste-
products containing nitrogen are eliminated in the urine.

The most easily understood function of tha kidneys

THE RESPIRATORY AND CIRCULATORY SYSTEMS 177

is the excretion of the urinary water; this varies in amount
with the rapidity of flow through the renal vessels and
to some extent on the blood-pressure.

The separation of the solid substances of the urine
form the next function of the kidneys, and these substances

Fig. 11. — Relation of kidneys to heart and great blood-vessels: A,
Heart; B, B, kidneys; C, bladder (after Quain).

fall into two groups — inherently useful materials, which
are in excess or which have served their purpose, and
substances which are inherently harmful. The latter class
embrace many end-products of metabolism, which we are
accustomed to consider as normal constituents of the urine.

14

178 PERSONAL HYGIENE FOR WOMEN

The analytic study of the urine is of great value to the
physician and surgeon, because of the knowledge which
it gives concerning the processes of metabolism occurring
within the body. The nature and amounts of the various
end-products of metabolism are carefully investigated as
they occur in the urine, whether they be normal or patho-
logic.

The Urine. — The normal human urine recently passed is
a clear liquid, of a straw color, with an average specific
gravity of 1020, the specific gravity indicating the amount
of solids contained in the urine. It is acid in reaction.
The quantity for twenty-four hours is 50 ounces, or
about 3 pints, depending on the amount of water ingested.
During sleep the amount secreted is less than at other
times. The amount of urine is decreased after profuse
sweating, diarrhea, thirst, diminution in the blood-pressure,
and after severe hemorrhage. When the body temper-
ature is considerably higher than normal, the amount of
urine is again diminished in quantity.

Urea forms nearly one-half of the solids in normal urine
and nearly one-half of the urea is nitrogen. It is the
principal representative of the waste of the nitrogenous
tissues. The chief source of urea is from the metabolism
of the muscles; the ingestion of a large amount of proteid
food stimulates metabolism. The quantity of urea
passed in the twenty-four hours is about 500 grains.

The uric-acid constituent is very small, and in the
human urine scarcely reaches 0.03 per cent, of the solids.
Lack of exercise leads to an increased formation of uric
acid by a lessening of the oxidation of the tissues. In
gout the amount of uric acid excreted is abnormally small,
because it accumulates in the blood and tissues. The
brick-dust deposit sometimes seen in the urine is composed
chiefly of the urate of sodium. The average daily amount
of uric acid passed in the human urine is about 7 grains.
The excretion of uric acid may be increased by drinking
copious drafts of water.

Toxicity of the Urine. — After the removal of both kid-

THE RESPIRATORY AND CIRCULATORY SYSTEMS 179

neys the animal dies of uremia; that is, there is an accu-
mulation of urinary products in the blood. The removal
of one kidney is not necessarily fatal, and women have
so lived very comfortably for many years. A human
being excretes enough poisonous material by the kidneys
in two days to cause death.

The Urinary Excretory Apparatus. — After the urine
has been secreted by the kidneys it must be carried away
from the body, so that the economy may not suffer from
the resorption of the contained toxic principles. The
excretory apparatus comprises the ureters, the bladder,
and the urethra.

The ureters are two cylindric tubes of the diameter
of a goose-quill and about 15 inches long. They make
their exit from the inner border of the kidney, and pass
downward and inward toward the median line, to empty
into the base of the bladder by a slit-like orifice.

The bladder is the reservoir for the urine. It is a
musculomembranous sac, situated in the pelvis, and in
the female it is in front of the uterus and above the vagina.
It normally contains one pint. It should be emptied four
times a day. If it is allowed to go longer than this, it
becomes overdistended, and is apt to displace the uterus
backward, and the bladder-walls themselves become
weakened.

The Physiology of the Female Generative Organs. —
The internal and essential organs of generation are the
uterus, ovaries, and the Fallopian tubes. These organs
have to do with the process of ovulation, menstruation,
and reproduction.

The Ovaries, — These are two small bodies of an almond
shape, and lie one on either side of the uterus. The bulk
of the organ consists of connective tissue, in which lie
embedded the Graafian follicles, or ovisacs, in which the
ova are contained.

During the child-bearing period, or from about the age
of fifteen to forty-five years, the development of the
Graafian follicles and the discharge of the ova are con-

180 PERSONAL HYGIENE FOR WOMEN

tinually taking place. The liberation of the ova usually
takes place at definite times, which, in general, coincide
with the menstrual epochs, one or more ova being set
free at each period, but this is by no means invariable.

The Uterus. — The virgin uterus is a small, hollow,
muscular organ, somewhat pear shaped, whose cavity is
about 1^ inches deep. The uterus is situated in the
middle of the pelvic cavity, between the bladder and the
lower bowel. It is held in position by broad elastic
bands, which go to different sides of the pelvis; it is also
in part supported by the structures below and above it;
but so loosely is the uterus held that it is easily pushed
about, as, for instance, by a full bladder or a packed
bowel, and persistently allowing the bladder to become
overful, and failure to have a daily evacuation of the
bowels, are prolific sources of displacements of the womb.

Respiratory Movements of the Uterus. — When no constric-
tions are placed about the waist, the uterus moves freely
up and down with every respiration. So distinctly, and
with such regularity, do these movements occur that an
operator, by watching the movements of the uterus,
can tell the effect that the anesthetic is having on the
patient's breathing. These so-called respiratory m6ve-
ments play a very important role in the circulation of the
uterus, and in the return of the venous blood to the heart.

Anything which interferes with these movements, as
the wearing of corsets or of tight bands about the waist,
prevents the free return of the venous blood. The uterus
becomes congested, and through the constant abnormal
weight of the organ itself, as well as by the pressing down
upon it from above of the superincumbent organs, the
uterus is pushed down below its normal position, the
ligaments whose duty it is to hold it up become relaxed,
and the unhappy woman suffers all the agonies that are
attendant on the "falling of the womb." For this reason
the disorder is frequently met with in women who have
never borne children as well as in those who have.

The Functions of the Uterus. — The function. of the

THE RESPIRATORY AND CIRCULATORY SYSTEMS 181

uterus is to provide a favorable place for the reception
of the product of conception, where it may be protected
and nourished during the period of its development.
The purpose of menstruation is to keep the uterus in
suitable condition for the reception of this product of
conception at any time. It is now known that the
menstrual flow is not the whole of menstruation, and that
the changes going on in the uterus are almost as continuous
as the process of digestion.

Average Duration of the Menstrual Flow. — The average
duration of the menstrual flow is five days, although
the variations are considerable in healthy women. A
flow lasting any place from two to six days is perfectly
consistent with health, but a flow continuing less than
two days or more than six days generally indicates a
local or general disease.

Character of the Menstrual Flow. — For the first few
hours, or perhaps for the first day, the flow is usually
slight in quantity and light in color; on the second and
third day the flow reaches its height, and is profuse and
dark in color, but it should never be clotted; after this
it generally ceases. The amount of the flow varies from
5 to 10 ounces. If less than 5 or 6, or more than 18
napkins, are pretty well saturated through, the amount
may be considered abnormal.

Premonitory Symptoms of the Flow. — The premonitory
symptoms of the monthly flow should not be so marked
as to cause the individual any discomfort. The first
indication of the return of the period should be the flow.
There is generally a feeling of abdominal fulness, with
some lassitude and sometimes slight headache. The
temperature is lower and the pulse is slower than at other
times. This lowered tone of the system is an additional
reason for increased care against exposure in wet or cold
weather.

Hygiene of Menstruation. — During the menstrual
period all cold baths must be strictly prohibited, whether
tub-baths or cold sponges. The reason for this is that the

182 PERSONAL HYGIENE FOR WOMEN

application of cold to the surface causes a driving in of
the blood from the exterior of the body to the internal
organs, and, at the time of the menstrual periods, there
is already a congested condition of the pelvic organs,
and it must be remembered that congestion is the first
stage of inflammation.

Hot or warm sponge baths may be taken throughout
the period, and the vulva should be bathed with warm
water twice a day throughout the entire period of the
flow, as this not only removes the clotted blood before
it decomposes and becomes the source of irritation, but
also removes other irritating matters, and prevents the
nervousness that is caused by local irritation.

Another question which is still sub judice is the necessity
for and the frequency with which vaginal douches should
be taken; all physicians are agreed that a vaginal douche,
taken immediately after the menstrual period, is beneficial,
as it removes all of the debris of the flow, which is some-
times very irritating.

Exercise. — A moderate amount of exercise should be
taken every day; this is needed now quite as much as
at any other time, and only good can result from it,
and no harm comes of a woman going out in the rain or
the cold weather. As has been shown, the menstrual
process is going on for a large part of the time, and the flow
is only the external appearance, but during the time of
the flow the woman must be unusually careful not to
get her feet wet or sit down with damp clothing on.
Violent exercise of all kinds is to be prohibited at this
time, as dancing, bicycling, gymnastics, and walks of
over three miles. The reason for this is very obvious:
the uterus has now reached the height of its turgescence,
and is heavier than at any other time, hence the danger
that displacements or a very profuse flow would be caused
by any kind of violent exercise.

Treatment. — If the woman has been so unfortunate
as to have been caught out in a heavy rain, so that her
clothes have been wet through, or if in the cold weather

THE RESPIRATORY AND CIRCULATORY SYSTEMS 183

she should come into the house thoroughly chilled, the
best thing to do is to take off her wet things as quickly
as possible; be well rubbed down with hot rough towels;
drink a cup of hot tea, and go to bed at once, with a hot-
water bag placed over the abdomen or under the small
of the back. She should remain in bed until the next
morning, to the end that the circulation may regain its
equilibrium as quickly as possible by the immediate
relief of the pelvic congestion.

If this exposure should have caused the sudden cessa-
tion of the flow, a hot mustard foot-bath should be taken.
One tablespoonful of ground mustard is used to the
gallon of water, as hot as it can be borne; the pail should
be made as nearly full as possible, without running over,
arid a blanket wrapped about the pail and woman, so as
to cause a profuse perspiration; this should be kept up
for ten minutes; as the water cools off, hot water may be
added.

Profuse menstruation, painful menstruation, and scanty,
very slight, or irregular flow are all abnormal conditions
that are due to some abnormal or pathologic causes, and
a good gynecologist should be at once consulted, so that
not only suffering may be prevented, but that serious
consequences to the general health may be averted.

CHAPTER VI

The Brain the Master Organ of the Body; the Functions of the
Brain; Habit and Automatism; the Physiology of the Brain and
Nervous System; the Hygiene of Work; the Toxins of Fatigue;
Overwork; Signs of Overwork; Nature's Restoratives; Avocation;
the Physiologic Necessity for Laughter; Vacations and Health;
Sleep; Insomnia.

The Eyes; Eye-strain; Description of the Visual Apparatus;
Optical Defects and Their Correction; the Mechanism of Eye-strain;
Local Symptoms of Eye-strain; Artificial Lighting; Hygienic
Precautions in Reading and Sewing; Injuries to the Eyes; Symp-
toms and Treatment of Conjunctivitis; Trachoma; Styes.

Functional Nervous Disorders, Headache; Neurasthenia.

The Brain the Master Organ of the Body.— The
brain is not only the most important organ in the body,
but its essential organ, for the sake of which all the other
organs and tissues exist, and it is the master of the whole.
It not only receives help from every other organ, but
it also largely controls the working of each. By its mental
action alone it can hurry the heart's beat or slow its pace ;
it can make the skin shrivel or flush; it can quicken or
stop digestion; it can stop or change the character of all
secretions; it can arrest or improve the general nutrition.
Every organ and every vital process is represented hi the
structure of the brain, by special centers and groups of
cells that have a direct relation with such organs and
processes, and through which they are controlled.

The Functions of the Brain. — The brain may be said
to have four chief functions; the first is that of motion;
it presides over and stimulates all the voluntary muscular
movements of the body, regulating their force, and co-
ordinating in their working the different groups of muscles

184

NERVOUS SYSTEM BALANCE OF POWER IN BODY 185

needed to perform them. Mind and muscular movement
have the closest possible connection with each other.
The second function of the brain is that of feeling and
sensation; the third is that of nutrition; through this
its own nourishment and that of the rest of the body is
regulated. While mind is the fourth and highest form
of nerve force, it is not created in the brain, but is abso-
lutely conditioned by that organ.

Different groups of brain-cells have different work as-
signed them; some have motion, some have sensation,
some have nutrition, and some have mind. For example,
special tracts of brain govern inhibition. While every
group does its own work, it is related to and combined
with others, influencing them, and being influenced by
them.

Every kind of mental activity uses up the brain energy
of the cells. To think clearly, plenty of healthy blood
must be supplied to the cells. In order to make healthy
blood, there must be an abundance of fresh air supplied
to the lungs, and a vigorous heart to pump it up to the
brain. It has been demonstrated that, during intellectual
work or emotional feeling, there is an increased supply of
blood to the brain, which may become more or less con-
gested, and that there is an actual rise of temperature;
whereas during periods of relaxation, rest, or fatigue, the
brain is pale and anemic.

The brain-cells generally, but particularly those cells
involved in mental activity, are of such a nature and con-
stitution that they cannot rest absolutely during the
waking hours. They may act slowly or with great
rapidity; different brains have different capacities for
energizing, both in regard to speed and force; and,
further, the brain may be pushed to work greatly in excess
of its normal activity, just as an engine may be allowed
to go at the rate of 50 or 60 miles an hour, or may be
pushed to go at the rate of 100 miles an hour. In both
cases the danger resulting from speeding are greatly in
excess of going at the normal rate of speed.

186 PERSONAL HYGIENE FOR WOMEN

In any case, the continuous brain action implies the
necessity for continuous repair. The only complete
physiologic rest which the brain enjoys is during sleep,
when the process of repair goes on most rapidly; during
this period the brain-cells absorb their nourishment from
the blood in excess of their needs, and so lay up a store of
energy for the waking hours.

Habit and Automatism. — It is one of the innate
qualities of every tissue and of every organ in the body,
that when any vital action is performed, any vital proc-
ess gone through with, it is easier to do it the second time,
and the continuous exercise of the action makes the per-
formances more and more easy, until they become auto-
matic.

The physiologic basis of habits consists of the plasticity
of the nerve substance, and in the capacity of nerve sub-
stance to receive and retain impressions. There results
the certainty that the nervous system will act again
more easily in those ways in which it has already acted.

On the one hand, the automatic performance of work
saves an enormous amount of brain energy; on the other
hand, bad habits may be formed whose effects may be
most pernicious, and which are gotten rid of only with the
greatest difficulty. An example of the first is the young
child learning to walk; at first he accomplishes the feat
only by the fixed concentration of every power of the
brain on the act; whereas the healthy adult walks
automatically, without paying the least regard to the
movements or the manner in which they are accomplished.
Hysteria and ungovernable outbursts of passion furnish
good examples of the bad habits that may be formed,
owing to the lack of discipline and the powers of inhibi-
tion ; every time that a woman gives way to one of these
outbursts, so much the harder will it be for her to prevent
or control another outbreak. Inhibition is the highest
and most important function of the brain.

Habits woman must have, but it is for her to choose
what they shall be, provided she chooses quickly; the

NERVOUS SYSTEM BALANCE OF POWER IN BODY 187

time limit in habits is one of the strong evidences of the
close connection of body and mind. It is a startling fact to
face, that a woman's habits are largely fixed before she
is twenty; that the chief lines of her future growth and
acquaintance before she is twenty-five; and her profes-
sional habits before she is thirty; yet to something like
this James believes that physiologic psychology points.
The woman becomes a bunoUe of habits, and her habits
settle about her like a plaster cast.

The Physiology of the Brain and Nervous System.—
The brain, spinal cord, and spinal nerves constitute the
so-called cerebrospinal nervous system. The brain is
that portion of the nervous system which is contained
within the cranial cavity and which it completely fills.
The spinal cord is the continuation downward, from the
brain through the spinal canal, of nerve substances, and
from which the spinal nerves are given off. The nerves
may be described as cords and threads of varying degrees
of fineness, distributed to every tissue and organ in the
body.

The nervous system has been likened to the electric
telegraph, the brain being the central station, while, in
addition to the special senses, the body is provided with
numerous terminal substations in the skin and internal
organs of the body, which keep the brain informed of
what is going on in the world around it, as well as in the
various parts of the body. The nerves simply act as
conductors to transmit the messages. The body is
supplied with two distinct sets of nerves or wires, one
of which carries messages from the outside world and
various organs to the brain, while the other set transmits
orders from the brain.

The spinal cord is the center of reflex acts; that is,
if the leg of a brainless frog is touched with acid, he will
take the other leg to wipe it off with. There are, as
we have seen, substations in the skin, hence the acid
causes the sensation of a foreign body, word is telegraphed
the spinal cord, where there is a large central station;

188 PERSONAL HYGIENE FOR WOMEN

from here word is sent out by another set of nerves, to
move the leg away from the acid, but this being insufficient,
word is telegraphed to the other leg to wipe off the offend-
ing substance. Did the same thing happen in the body,
at the same time that the cord telegraphed word to the
affected member to withdraw it, it would telegraph the
brain, and the sensation of pain would be felt.

A message travels along a nerve at the rate of about
thirty-six yards a second, or a mile a minute. This is
about the time made by a lightning express train. The
distance in the body being so short, the time taken is
imperceptible, and we say that movement is instantaneous.

The paths traveled by nerve impulses are made passa-
ble by use; the oftener an impulse traverses a given
route, the more adapted such a route becomes for future
traffic.

But all of this has to do with the nerves which are
under the control of the will. There is another set of
telegraph wires in the body, called the sympathetic or
vegetative system, so-called because it presides over
the processes of nutrition and is beyond the control of
the will. ,-

The Hygiene of Work. — Since the motor centers are
located in the brain, it is natural to expect that all de-
finitely directed movements will directly affect the brain
and the mental development, and so it is. Du Bois
Raymond says that it is easy to demonstrate that such
bodily exercises as gymnastics, fencing, swimming, riding,
dancing, and skating are much more exercises of the
central nervous system, of the brain, and spinal cord than
of the muscles.

It is further urged that healthful energy of will is
impossible without strong muscles, which are its organs,
and that endurance, self-control, and great achievement
all depend on muscle habits.

The philosophy of work consists in its necessity. The
brain-cell in health cannot cease to be active, except to
a partial extent during sleep. There must be somfe output

NERVOUS SYSTEM BALANCE OF POWER IN BODY 189

of mind from the mind cell and of motor stimulus from
the motor cell. The proper selection of work for that
particular brain to do, and the physiologic regulations
of the work done, is the basis of the hygiene of work.
For health, for happiness, and for efficiency, right work
rightly done is the most important matter in any man's
or any woman's life.

The physiologic, as well as the moral necessity, has
always been conceded for every man to have a life-work —
a vocation; a work for which he should be fitted, and
for which he was capable, sufficiently congenial not to
sink into mere drudgery, and which would, at the same
time, afford ample financial compensation to be remunera-
tive and a stimulus to his power of endurance.

Important, from a physiologic point of view, as a
vocation is for men, it is equally or even more important
for women. It is highly probable that the unstable
nervous system of women and their emotional extrava-
gance and dissipations, whether of frivolity, wickedness,
or grief, is largely due to lack of mental discipline and
muscular development. It is a psychologic proposition
that any woman who has a toothache suffers less if she
keeps busy, and any one will testify that she suffers much
less from the intense heat of summer if she is busily
employed.

One of the great objects of a definite and fixed occupa-
tion is to turn the thoughts out from the ego. Work of
some kind is indispensable to the health and happiness
of every one, since it necessitates an objective instead of
a subjective attitude of mind.

Experience teaches that the brain, like the muscles,
is subject to training; occasional excessive efforts, with
long intervals of repose, are rather injurious, while a many-
sided activity, constantly repeated, interrupted by suffici-
ent shorter rests and supported by sufficient nutrition,
is strengthening. A healthy training of the brain should
be as many sided as possible.

Symmetric development and training of every func-

190 PERSONAL HYGIENE FOR WOMEN

tion of the brain is as essential for mental efficiency and
sanity as the development of all the muscles of the body
is for bodily vigor, and a one-sided training of the mental
powers is as certain to produce eccentricities of habits of
thought and actions as those occupations which call
into play only the action of certain groups of muscles is
to cause bodily deformities. Anything which will prove
injurious to the delicate nerve substance must be avoided,
as laziness, idleness, and, worst of all, any form of nar-
cotics.

Many-sided life work, consistently carried through, not
only strengthens the brain, but also its continued power
of adaptation, and one's whole life is a continuous struggle
for adaptation. The more the brain works, the more
capable it is of receiving new impressions and elaborating
old ones, and it retains its elasticity longer.

Hurry generally implies lack of system in carrying out
the routine of work, or the undertaking of more work
than the individual can accomplish without injury to
herself. Few things can more certainly muddle the brain
and produce a sense of physical exhaustion than a sense
of hurry. Without the sense of this insane driver with
a lash in his hands standing over one, she can work more
rapidly, with complete self-possession, and do more
accurate and better work. The peculiar sense of being
hurried has a direct benumbing physical effect, that can
often be felt in the brain as distinctly confusing.

The Toxins of Fatigue. — By speeding the machinery
to the utmost, a strain is placed on nerves and muscles,
and they are kept keyed up to the greatest possible ten-
sion. There is a natural pace that one can keep up;
force the pace, and weariness results. A man can go for
hours at the rate of five miles an hour; he can run at
the rate of six miles an hour for quite a long while; but
if he tries to run eight miles an hour, he will drop out
very soon. The powers of endurance must be gradually
developed, but no machine should ever be run at its
utmost speed.

NERVOUS SYSTEM BALANCE OF POWER IN BODY 191

By undue pressure, at any period of life, it is possible
to use up energy that ought to have been spread out over
long periods ; and this is emphatically the case during
adolescence; too heavy a drain is made on futurity,
which means a serious breakdown, or, at least, premature
old age.

It has long been assumed that during the activity of
muscles substances were produced which exerted a
poisonous influence upon the muscle tissues. Exactly
what these substances were was not known, but it was
supposed that they were definite products of metabolism
or tissue waste. It is a well-known phenomenon, observed
during the training of athletes and soldiers, that pro-
longed and disciplined exercise makes it possible for
individuals to support easily an amount of work which
would prove exhausting or even fatal to the untrained.
Increased work, under any circumstances, means increased
metabolism, and consequently a more rapid accumulation
of its products.

A German investigator, Dr. Weichardt, has shown that
if guinea-pigs were put upon a miniature treadmill and
forced to run it until they dropped dead from exhaustion,
a highly poisonous liquid could be pressed from their
muscles, and that the injection of this liquid or extract
into the veins of healthy guinea-pigs produced, when
administered in small doses, rapid fatigue; whereas,
larger doses caused death, accompanied by all the symp-
toms observed in the original animal during the process
of mechanical tiring.

On the other hand, liquid taken from un worked guinea-
pigs had no such effect. Further, that if these little
animals were put upon a treadmill and worked to just
short of exhaustion, and then were given time to re-
cuperate, as we say, the liquid or extract from their
muscles had no such effect: it was quite harmless.

From the results of these carefully carried out scientific
investigations, Weichardt has come to the conclusion
that fatigue is due to a definite toxin, analogous to that

192 PERSONAL HYGIENE FOR WOMEN

of diphtheria and tetanus, and he believes that the ex-
planation of the phenomena of training lies in the fact
that in the body of the athlete there must be a specific
"antibody," which neutralizes the "fatigue toxin" as
soon as it is formed.

In the animals undergoing these experiments of extreme
fatigue there was a fall of temperature. A practical use
of this fact could be made for the individual, by noting
the fact that a subnormal temperature was a grave
danger-signal.

Other observers concede that fatigue is due to chemical
substances, produced in the body as the result of brain
and muscle activity, and find that these toxins produce
a depressing effect, especially on the muscular system,
and that the sensation of fatigue is in large part the
manifestation of this depression. The action of toxins
is not confined to the tissues in which they arise; exces-
sive activity of one tissue can cause fatigue of others.
The facts of acid intoxication are noticed as analogous
to fatigue phenomena, so far as the latter are due to
toxic substances. As antidotes, only rest and sleep can
be relied upon.

Observations in the electric experiments on nerve-cells
have shown a remarkable shrinking of the nerve-cells,
and especially of their nuclei. After five hours' con-
tinuous work, the cell nucleus was only half its normal
size, and twenty-four hours of rest was necessary in order
to restore it to its normal size, but half that amount of
work does not require half that amount of time for its
recovery.

The mental symptoms of normal fatigue are loss of
memory; the sense of perception is less acute; the associa-
tion centers aot less spontaneously and therefore slower;
the vocabulary diminishes; the emotional tone is lowered;
the attention is unstable and flickering. All these are
marked symptoms that the individual is far below her
best. All kinds of perceptions are more acute in the
morning.

NERVOUS SYSTEM BALANCE OF POWER IN BODY 193

Fatigue is not, therefore, merely physically uncom-
fortable; it is intellectually, physically, and morally
dangerous.

Overwork. — A surplus nervous energy must be per-
sistently aimed at — what Emerson calls "plus health."
It must be indelibly impressed on the intelligence of
every one that no fatigued individual can be at her best;
she is doomed to do inferior work, to be mentally de-
pressed, and to be morally weakened. Hope and courage
ooze away, and all sense of proportions and perspective
are lost.

The amount of work that can be performed without
fatigue is a matter of individuality, and the only safe
gauge of overwork are the danger-signals sent out by
nature — loss of appetite, insomnia, increasing exhaustion
from day to day without increase in the amount of work
done, mental depression, lack of interest and initiative.
No one can afford to disregard these danger-signals.

Habitual overwork produces fag and a desire for
stimulants to act as a spur to the overworked muscles
during the day, and recourse to increased stimulants or
sedatives to act as hypnotics at night. The inert nerve-
centers have no reserve energy to give out, so it is worse
than useless to stimulate them. On the other hand,
the nerve-centers are at too low an ebb to react from
the depressing effects of sedatives, which, to the indi-
vidual, must be positively injurious. The aim must be
to promote nutrition, and to give complete rest to the
exhausted nerve-centers.

Brain work, to be beneficial, must be regulated with the
greatest care. During the exercise of the brain there
is always an increased blood-supply to it. If the exercise
is continued too long, there is a tendency for the blood
to remain in too great quantity, due to the exhaustion
of the nerve-cells, which are no longer able to control the
vessels.

During sleep the blood-supply to the brain is diminished
and the cells recover themselves, but if this hyperemia

13

194 PERSONAL HYGIENE FOR WOMEN

be persistently kept up, sleep soon becomes impossible,
the brain-cells have no opportunity to become repaired,
and their activity is diminished.

Richardson says: " Making all allowances for differences,
even in the prime of their mental and physical vigor,
few individuals can exceed six, and for most persons
prudence would direct not more than four or five hours
of close mental application, without seriously endanger-
ing their health."

No real advantage is gained by eight or ten hours of
daily study, since the memory and reasoning powers
become so exhausted that the assimilation of ideas
becomes slower and more difficult. When in his prime,
Walter Scott declared that six hours a day was aU that
he could profitably spend upon his literary compositions.
In later years, because of his pecuniary embarrassment,
he worked beyond this limit, and, as the result of exces-
sive labor, his last years were spent in hopeless imbecility.

Signs of Overwork. — These show themselves in
irritability, with a sense of exhaustion, the irritability
being due to an exhaustion of the nerve-centers. Work
becomes irksome. There are periods of depressioi} and
melancholia, which recur at shorter and shorter intervals
and continue for a longer period of time. There is a slight
loss of memory, together with inability to concentrate
the mind upon any given subject for any considerable
length of time, and the power of thought and judgment
are impaired. There are sleepless nights, ringing in the
ears, fatigue from the slightest exertion, an irregular
action of the heart, with palpitation and a frequent desire
to urinate. Various forms of pain and neuralgia occur.

There may be as yet no loss of flesh or impairment of
the appetite, but this condition of cerebral anemia
furnishes the possessor with a pair of blue spectacles
through which the intelligence must look, and which throw
their own color over everything. Distressing dreams
and unrefreshing sleep allow the brain little opportunity
for either rest or repair. The mind becomes as* sensitive

NERVOUS SYSTEM BALANCE OF POWER IN BODY 195

as the skin after a blister, and the calm, vigorous mental
labor is superseded by feverish anxiety, wearing responsi-
bility, and vexing chagrin.

When the brain is well supplied with a powerful circula-
tion, and a rich blood-supply from a good digestion
furnishes it with an abundance of pabulum, the cares of
life are borne with equanimity and cheerfulness. One
of the most unerring signs of failing health is the inability
to withstand the pressure of these same daily cares.
When the cares that formerly sat lightly on the shoulders
become well-nigh an insupportable burden, a state has been
reached where the mind reacts on the body.

Worry. — It is readily evident that worry is bred of
exhaustion, and is one of the signs of overwork; but, if
too often indulged in, it becomes a fixed habit, and the
mind rapidly becomes settled in a state of gloom.

It is most important for overwrought business and
professional women, but most especially for those women
whose vocations in life combine three distinct occupa-
tions or callings — namely, wives who act in the capacity
of housekeepers, ministers of finance to the household,
and the bringing up of children — to realize the importance
of not undertaking more than they can accomplish with-
out fret and worry. The overconscientious woman may
object that it is selfish to consider her own comfort
when she has work to do for others, but to expend too
freely of the nervous energy, even in a good cause, is like
giving so much of our substance to charity that we our-
selves are in turn obliged to lean on others for support.
In properly conserving our own energies, we may ulti-
mately be lightening the burden of others. There is a
proper balance between the duty one owes to one's self
and to others.

Once bred, worry is an endless chain. Tell such a
woman not to worry, and she worries for fear she may
worry. She is afraid that she has decided wrongly, and
regards decisions hi regard to the most trivial affairs of
life as though they were matters of vital importance.

196 PERSONAL HYGIENE FOR WOMEN

The obsession "to arrive" is a fertile source of fret and
worry. This habit of mind leads to frantic and incessant
labor and blocks all pleasure at every point. The person
who plays a game only to see who wins, loses half of the
benefit of the recreation.

"The legs of the stork are long, the legs of the duck
are short; you cannot make the legs of the stork short,
neither can you make the legs of the duck long. Why
worry?" (Chinese proverb.)

Insomnia. — This is another symptom of overwork.
The mind, worried and harassed all day, retires at night
to struggle in the darkness and solitude with worries,
forebodings, doubts, and regrets, which now assume
gigantic and fantastic shapes. In this case the insomnia
is due to faulty habits of mind.

Another form of insomnia is caused by intellectual
work being carried on at night until time for retiring;
the mind is then so fully saturated with the subject
that it is unable to throw it off on going to bed.

Whatever be the cause of the insomnia, it soon becomes
a fixed habit, and, whether it is a case of laying awake a
long time before sleep comes, or waking up at a regular
hour toward morning, — and it is a curious fact that the
habit of waking up recurs at almost precisely the same
hour in the morning, — the longer this habit of insomnia
is indulged in, the more difficult it is to break it up.

Nervousness. — This is a well-known sign of overwork,
which shows itself in intense nervousness and irritability.
Everything jars on the nerves. The woman gives way
to her emotions, over which she loses control.

To keep placid when overworked to the limit of physical
endurance requires a stolidity of soul and lack of nerves
only known to the North American Indians, and perhaps
the Japanese, and it matters not what the kind of over-
work is, whether business, pleasure, or charity.

Nature's Restoratives. — The proper division of the
day is eight hours to be alloted to work, eight to sleep,
and the remaining period of eight hours is to be divided

NERVOUS SYSTEM BALANCE OF POWER IN BODY 197

among the various methods of refreshing body and mind
—the toilet, eating, rest, and recreations.

Not only are rest, recreation, and sleep in proper
proportions essential to the health of the body, but
they are equally essential to the quantity and the quality
of the output of work. From them result a feeling of
physical well-being, an exuberance of animal spirits
which go into the work. The perspective is more ac-
curate, the judgment is clearer, and the creative power is
greater. Work goes of itself with a swing. Happiness
is an expansive quality, that makes itself felt throughout
the entire body, but its effects are most manifest in the
mental power.

The mother who so honestly works and plans for the
good of her family as to give herself no time to rest after
her physical efforts is in such an exhausted condition
as only to be able to give them the tired and critical side
of herself for daily association. There are few human
achievements much finer than to make human beings
happy, and this power woman is endowed with to a very
large extent.

Rest, to be of value, must be systematically taken.
Bearing in mind the shrinking in size of the nerve-cells
after stimulation caused by work, and that they recovered
their normal size in relatively less time if the shrinkage
were less, it becomes obvious that, in order to accomplish
the best work, whether purely mental, or of the more
complex mental and physical work demanded of the
mother who is at the same time the housewife, that a
break in the day's work will aid in securing the best
results.

The exact time of the daily siesta must be adapted to
the family regime, but a fixed hour should be set aside
for this purpose, and this should be known as the mother's
hour, and nothing short of a catastrophe should be allowed
to infringe on it.

The woman should retire to her bed-room, undress,
and go to bed. The room should be darkened, and at

198 PERSONAL HYGIENE FOR WOMEN

the same time there must be an abundant supply of fresh
air. One soon forms the habit of taking a short nap, of
perhaps hah* an hour; one hour should be spent in bed.
After this, she gets up, takes a shower or other bath,
dresses, and is then ready to enjoy life and be a comfort
to her family. In this way alone can absolute relaxation,
rest of mind, and body be secured.

Avocation. — Second only to the physiologic necessity
for a vocation in life, is the necessity for an avocation,
and this must be in the nature of a recreation.

It is a well-known fact in farming that any one kind
of crop will exhaust the very best soil, but few people
recognize the necessity for a change of occupation and
recreation in order to produce the best mental and
physical results.

Joyless drudgery drains the springs of health. There is
a mental starvation, due to the lack of recreation, as well
as the physical, due to the lack of bread. The French aris-
tocrats, noted for the gaiety of their pastimes, in spite
of their dietetic and other sins, furnish a remarkable list
of longevity. Persons of a cheerful disposition are
generally long-lived, and anything tending to counter-
act the influence of worry and discontent directly ton-
tributes to the preservation of the health. Despair, which
frequently results from years of overwork, can paralyze
the energies of vital functions like a sudden poison, while
hope fulfilled has cured many a disease.

The nature of the avocation chosen will necessarily
depend upon the character of the vocation. For women
whose vocations are intellectual and sedentary, as writers,
teachers, stenographers, etc., some outdoor employment,
which calls into activity the muscles of the body, rests
the eyes and brain, and, at the same time, pleasantly
occupies the mind, is the best, as walking, gardening,
lawn-tennis, golf, rowing, etc.

For all women engaged in sedentary occupations, daily
exercise in the open air is the first essential, and let them
be assured that their feelings of fatigue and disinclination

NERVOUS SYSTEM BALANCE OF POWER IN BODY 199

to exercise are no safe guide as to their ability to take
exercise.

The first cause of the feeling of fatigue is due to the
lack of oxygen in the lungs and the impure air of the
room. On going out-of-doors, the woman will be surprised
at how much stronger and better she feels after an hour's
brisk walk than she did on starting out.

"Fancy work" and lace-making, instead of being
classed with recreations, must be classed with fine hand-
sewing of the most taxing kind. It calls the same groups
of muscles into play, and is productive of the same evils,
with a greater tendency to produce eye-strain and a
paralysis similar to writer's cramp.

The proper avocation of the tired housewife, who has
been on her feet all the time and whose vocation is manual
labor, will be the diversion of the mind by reading a
good book, while comfortably pillowed on a veranda
chair, a drive, a visit to some congenial friend, a game of
cards, or music.

Literary clubs for women should be more largely organ-
ized through the country and in country towns. In the
cities women have found these clubs a great boon, not
only to the health and happiness, but they are in the
highest degree educational.

Further, women have found that these literary clubs
were profitable, as a means of bringing their minds in
contact with other educated minds, and thus they had
not only the additional stimulus to study, but a broaden-
ing of their horizon, which the woman's heretofore shut-
in household life had precluded. Courses in domestic
science would be a boon to the home.

The greater the number of interests which education
and culture have created, the greater will be the diversity
of the recreations open for the woman's enjoyment.

Care must be taken that the avocation, which is at first
an enjoyment and relaxation, is not turned into hard
labor. The moment that any one strains every nerve,

200 PERSONAL HYGIENE FOR WOMEN

even to excel in a game, that moment it ceases to be a
relaxation.

History shows that the laws of all nations have always
provided a certain number of days of rest, or at least a
change of occupation, and that these days were fixed at
more or less regular intervals. This was partly from a
religious and partly from a hygienic standpoint. The
necessity for the interruption of the regular routine work
has always been recognized, and one day out of every
seven has been set aside for this purpose.

The custom that is so frequently adopted by city folk
of going out of town over Sunday might very well be
imitated by country folk by going into the town or city
over Sunday. For not only is the too continuous applica-
tion to one's employment fraught with danger, but it
has been conclusively shown that a monotonous routine
of occupation, such as lived by the average farmer's wife,
is a severe tax on the sanity of the mind. Statistics show
that the heaviest percentage of insanity falls on farmer's
wives, and the supposed cause of this is the monotony of
their lives.

A horse cannot gallop as many hours as it can walk,
and the daily task should be the sum-total of what man
or beast can do compatibly with health. To combine
a day of toil with a second of amusement in one twenty-
four hours does not give the proper allowance for sleep,
and cannot be done without injury to the individual.

Fun and laughter are the most efficacious remedies in
the pharmacopeia, and tired humanity owes a debt of
gratitude to the guild of humorists, be they writers,
comedians, or musical composers.

The Physiologic Necessity for Laughter. — The at-
titude of the individual varies with age, temperament,
and the perspective of life. Grave adults are apt to think
of laughter and smiling as something occasional, a momen-
tary lapse once hi a while from the persistent attitude of
seriousness. Healthy children, on the contrary, consider
that a state of laughter is the normal condition of Ruman'

NERVOUS SYSTEM BALANCE OF POWER IN BODY 201

ity, and that seriousness is a tiresome necessity, which
must be tolerated from time to time. But very few people
have any idea that there exists a well-defined physiologic
necessity for laughter, and the greater the intellectual labor
and the mental strain, the greater is this necessity.

The deep forcible chest movements increase the rapidity
of the circulation, the force of the heart's beat, and secures
a more complete oxygenation of the blood.

It is not improbable that this accelerated circulation
produces remote effects on the organism. One of the im-
mediate effects of a good laugh is that it relieves the brain
by the rapidity of the movements of the blood through
the capillary circulation.

In addition to the immediate physiologic effects which
result from laughter it is highly beneficial, by relieving
the brain and nervous system from the intense strain
and tension of the daily affairs and occupations of life,
and gives relief to the severely congested capillaries, which
otherwise involve considerable risk to the individual.

Physiologists hold that pleasurable feelings tend to
further the whole group of organic functions, and that
laughter produces a considerable increase of vital activity
by the heightened nervous stimulation. There is a sense
of increased energy, of a high tide of the fulness of the life
current.

Vacations and Health. — The secret of success of the
old Romans in conquering the world lay as much in their
ability to maintain the health of their troops in their va-
rious campaigns as by the courage and organization of
those troops; or, rather it may be said that courage is
but the coefficient of a good physique and a general men-
tal vigor.

A rest one day out of seven, with an occasional outing
for the week-end, is good but not sufficient. If one would
keep up to her highest standard of physical and mental
efficiency, she must have at least one month of absolute
change of environment and outdoor life in the year.

The kind of place one choses for her vacation will

202 PERSONAL HYGIENE FOR WOMEN

depend on where her home is. To dwellers in cities, the
mountains and seaside resorts are the most beneficial.
August is our most trying month, and every one who can
would do well to take her vacation at that time, always
selecting some resort north of her own home, so that she
may have the additional advantage of a more bracing
climate.

Maine furnishes many of the most beneficial of our
health resorts, combining as it does so many attractions —
its bracing atmosphere of pine forests, its beautiful
scenery with vast expanses of water, and the great variety
of diversions which it affords.

It is always wise to send an advance scout to investigate
the place in which you contemplate spending your vaca-
tion. Avoid low and swampy land; investigate the
character of the water-supply and the nature of the
plumbing, together with the sewerage system, for it is
all too frequent that an attack of typhoid fever follows
an outing in the country. Every good summer resort
should furnish facilities for a variety of outdoor sports —
golf, tennis, boating, swimming, etc.

During the vacation needless exposure to the direct
rays of the sun must be avoided. There is probably
nothing which lowers the vital resistance, and so prepares
the way for disease as much as exhausting exposure to the
hot rays of the sun.

Long hours of sleep should be indulged in. The morn-
ing air is the most beneficial; it is, therefore, a good habit to
retire early and to rise early.

If the vacation is not properly spent, it may be the
means of doing more harm than good. On the other
hand, if properly spent, vacations prepare one as nothing
else can to meet and resist the vicissitudes of the follow-
ing winter. It is the people who go off on long vacations
who have the least need of the doctor's care.

Sleep. — During sleep all the bodily functions are in
abeyance and the secretions are diminished; respiration
is slow and confined to the chest, so that the amount of

NERVOUS SYSTEM BALANCE OF POWER IN BODY 203

inspired air is only one-seventh of that during the waking
hours; the temperature of the body falls; less blood
circulates through the brain; and the sensibility of the
nerves to external stimuli is diminished. Sleep is not
only par excellence the time of repose and recuperation
of the brain and nerve substance, but it is the only time
when, by the diminution of waste caused by the incessant
activity of the brain, that the organ can be properly
nourished, the deficit in nerve force canceled, and the
surplus of energy stored up.

Without this absolute remission of brain activity every
twenty-four hours an actual destruction of substance
would occur, which, if persisted in, would be so depressing
to the nervous functions as to be inconsistent with life,
and this is the case in the concluding stages of fatal
diseases.

The sleepy feeling caused by fatigue is due to the
circulation in the blood of toxins resulting from tissue
waste, which benumb the brain-cells; while the feeling
of freshness and bien-etre with which one awakens in the
morning is due to the elimination of the fatigue products
from the blood during sleep. If the blood of a tired
dog be transfused into the veins of a perfectly fresh animal,
the latter will immediately show symptoms of somnolence
and seek a dark corner for sleep.

The medical authorities of to-day are pretty well agreed
that eight hours of sleep is the minimum required for the
maintenance of health, and all concede that the brain-
worker requires more sleep than the manual laborer.
Every moment after the feeling of languor presents itself
is a strain upon the nerves and muscles which will sooner
or later invalidate for life, and finally bring the victim
to a premature grave. Habitual deficiency of sleep will
undermine the strongest constitution.

It is a matter of great importance to train one's self
in the habits of sleep, regularity in the hour of retiring,
abstinence from active brain work for the hour immediately
preceding going to bed, since, if active brain work is con-

204 PERSONAL HYGIENE FOR WOMEN

tinued until one goes to her room for the night, the chances
are that the brain will continue its activities after getting
into bed, and sleep may be banished from the pillow
for several hours.

A few minutes spent in breathing exercises, the vigorous
use of the flesh brush or hair glove, a hot plunge or foot-
bath are no mean hypnotics.

A sound sleep is dreamless. Dreams require a certain
expenditure of nerve force and mental energy, so that
dreamless sleep is the most restful. Disagreeable dreams
and "night-mares" are generally associated with indiges-
tion and biliousness, which also occasion a general rest-
lessness. All this can be overcome by taking some med-
icine for the liver. Two grains of calomel taken just
before retiring often works like a charm. The dose must
not be repeated under a month. In case of tendency to
insomnia, no coffee should be taken after breakfast.

Treatment of Insomnia. — The mechanical measures
for the relief of insomnia have for their purpose the with-
drawing of the blood from the brain to the surface of the
skin. Hot foot-baths; general warm baths; cold douches
to the spine, brisk exercise; light massage, and cold rooms.
Mental work should be laid aside several hours before
retiring; late suppers avoided; coffee, if taken at all,
should only be taken for breakfast, and then only one
cup. Reading or amusement should be selected that
does not excite the nerves.

To woo sleep the woman should put herself in a position
of rest, which of itself physiologically induces sleep.
Avoid irritations, noises, bad air, cold feet, overloaded
bowels, all of which tend to wakefulness and to prevent
the proper physical rest. Then sleep usually comes of
itself.

The Eyes : Eye-strain. — Of all the misfortunes that
could befall a human being, the loss of sight is probably
the greatest, and yet no organ of the body is so constantly
abused as the eye.

The trouble is that the possessor of the normal eye

NERVOUS SYSTEM BALANCE OF POWER IN BODY 205

does not take into consideration that in all near work, as
in reading, writing, sewing, etc., the eye is actively
engaged as well as the hands and brain, and that the eye
only is at rest when looking into space or when closed.

Description of the Visual Apparatus. — The eyeball
is contained and protected in a bony cavity, formed by
the bones of the face and skull, and is supported by a
cushion of fat and other tissues. It is held in place by
its membranes and muscles, by which it is also moved.
It is further protected by the eyelids, the eyebrows, and
the eyelashes. The eyebrows protect the eyes from
dust and perspiration and shade the eyes.

The eyelids are lined by a very delicate mucous mem-
brane, called the conjunctiva. They are maintained in
close apposition to the eyeball by atmospheric pressure.
The tears are secreted by the lacrimal gland, which is
at the upper and outer angle of the orbit. The lubrica-
tion by the tears and the mucus secreted by the con-
junctiva cause them to move smoothly and without fric-
tion. An important function of the h'ds is to distribute
the tears over the front of the eyeball, and by incessant
winking to free the front of the eye from dust and to keep
it moist.

The conjunctiva is continuous with the mucous mem-
brane of the nose and mouth. Hence, in inflammation
of the nasal mucous membrane, as in an ordinary cold in
the head or influenza, the conjunctiva is liable to become
very much congested or inflamed.

The eyeball is spherical in form, having the segment of
a smaller and much more prominent sphere ingrafted on
its anterior part. The segment of the larger sphere, which
forms about five-sixths of the globe, is opaque, and forms
the sclerotic coat, the so-called "white" of the eye. The
smaller sphere, which forms the remaining sixth, is trans-
parent, and is formed by the cornea.

The iris is a circular contracting membrane, suspended
from the edges of the cornea, in front of the eye like a
curtain. The iris gives color to the eye, and when we

206 PERSONAL HYGIENE FOR WOMEN

say that an eye is blue or brown, we mean that is the color
of the iris. The iris is freely movable, and, according as
to whether it dilates or contracts, there is an alteration
in the size of the central aperture, called the pupil.

The chief function of the iris is to regulate the quantity
of light admitted .to the interior of the eye. In a very strong
light the pupil quickly contracts, shutting out the exces-
sive light, while in a subdued light the pupil dilates, thus
allowing more light to enter. When looking at a distance
or when looking languidly into space, the pupil dilates.

The Formation of the Image. — The eye is a camera, con-
sisting of a series of lenses and media arranged in a dark
chamber, the iris serving as a curtain. The object of the
apparatus is to form on the retina a distinct image of
external objects.

The Mechanism of Accommodation. — In the passive
condition of the eye, when it is adjusted for far objects,
the anterior surface of the lens is somewhat flattened.
Accommodation for near objects consists in a contraction
of the circular ciliary muscle and an increase in the con-
vexity of the anterior surface of the crystalline lens.

The light enters the eyeball through the pupil, /alls
upon the retina, which has often been compared to the
sensitive plate of a camera, is received and transmitted
by the optic nerve to the visual centers of the brain.
The eyeball does not see. It is only a sensitive end-organ,
which receives and transmits the impressions to the
higher centers of sight. The act of vision is performed
in the brain.

The focusing power of the eye is the property of bend-
ing nearly parallel rays of light from distant and divergent
rays or from close range so that they meet exactly on the
sensitive retina; this is called refraction. In the normal
eye these rays are focused exactly on the retina.

Optical Defects and their Correction. — In the normal
eye the near limit of accommodation is from 4 to 5 inches,
and the far limit may be put at an infinite distance.

Myopia or Near-sightedness. — This is one of fhe most

NBRVOU8 SYSTEM BALANCE OP POWER IN BODY 207

common refractive defects of the eye. In this condition,
because of the greater length of the eyeball or increased
refractive changes of the media, rays of light from a
distance are focused in front of the retina, producing an
indistinct image.

The near-point is brought much nearer — from 2 to 2$
inches — and the far limit is at a very short distance.

In reading, the myope is obliged to hold her book very
close to the eyes in order to see. In doing so, she strains
her muscles of convergence, producing ocular congestion
and compression of the eyeball.

The predisposing causes of myopia are heredity; it is
said that half of myopics are descended from near-
sighted parents; uncorrected astigmatism, and the effort
to read very fine print or figures, entails severe strain on
the eyes, which may result in myopia.

Myopia is corrected by a concave lens, which diverges
the rays of light, prolonging the focal distance, so that
the rays of light are focused exactly on the retina.

Not only are myopic eyes not injured by wearing suit-
able glasses, but, on the contrary, are often preserved
from injurious pressure on the globe, due to the indul-
gence of the habit to nearly close the lids in order to see
better, as is commonly done when glasses are not worn.

Hyperopia or Far-sightedness. — In this condition the eye-
ball is too short, and the rays of light from a distance
are focused behind the retina. Instead of being distinct,
the image is blurred. Hyperopia is corrected by a convex
lens, which converges the rays of light, bringing them
sooner to a focus. In the hyperopic eye the near-point
of accommodation is at some distance, and a far limit of
accommodation practically does not exist.

Presbyopia. — This is a loss of the power of accom-
modation, by which reading, writing, sewing, and other
near work is accomplished. This power of accommoda-
tion is greatest in early life, and gradually diminishes
until about the age of forty years, when reading at the
ordinary distance becomes uncomfortable. At about

208

PERSONAL HYGIENE FOR WOMEN

seventy-five years of age the power of accommodation
is practically lost.

Every person over forty-five years, with normal or far-
sighted eyes, should wear glasses to perform near work.

Astigmatism. — Astigmatism does not depend on the
length of the eyeball, but on the curvature of the cornea,
and rarely on that of the lens. Uncorrected astigmatism
necessitates the expenditure of more muscular effort in
the attempt to see distinctly than is necessary when

Fig. 12. — Astigmatic chart.

refraction is normal. This is accompanied by early
fatigue and more or less congestion of the vascular tunics
of the eye. Astigmatism is corrected by a cylindric lens,
which has a plane surface in one axis and a concave
surface in the axis at right angles to it.

In simple astigmatism, on looking at the accompany-
ing astigmatic chart with each eye separately, certain lines
in the defective meridian seem very much blurred, while
those at exact right angles appear clear and black. This

NERVOUS SYSTEM BALANCE OF POWER IN BODY 209

furnishes a test for astigmatism, since to the normal eye
the lines appear of equal distinctness and clearness.
Astigmatism is a very common ocular defect.

The Mechanism of Eye-strain. — Comparatively few
eyes are perfect. Far-sighted or astigmatic eyes can
secure perfect vision by means of accommodation. By
constant strain on the ciliary muscle, the crystalline lens
is so increased in curvature as to exactly counterbalance
the optical defect of the eyes.

Healthy eyes should do their work without the con-
sciousness of the owner, and this is a safe test as to the
kind and amount of work demanded of them.

Perfect rest for the eyes is impossible in the waking
state — distant vision represents rest for the eyes and near
vision exertion.

Near work is the chief cause of near-sightedness.
Distant vision should alternate with near work, and in
near work the object should not be brought nearer to the
eyes than 12 inches.

The Local Symptoms of Eye-strain. — There may be
a sense of fatigue in the eyes after reading for a short
time, and this may be followed by a constant sense of
discomfort in the eyes, which is increased on using them,
and which may be accompanied by severe pain in the
back of the head. There is a sensitiveness to light, and
inflammation of the eyelids and conjunctiva. There may
be twitching of the eyelids, and in extreme cases difficulty
in keeping the eyes open on account of drowsiness. The
eyes may smart, itch, or burn, and continually "water."

As the trouble becomes more pronounced, reading
for a short time may be followed by a blurring of the
type, and finally the lines may run together. There is
a constant sense of the eyes feeling for the lines, and,
perhaps one of the first things to call attention to the
condition of the eyes may be the losing of the lines in
reading.

The general or reflex symptom of eye-strain is head-
ache, which frequently takes the form of migraine. This

14

210 PERSONAL HYGIENE FOR WOMEN

is increased on reading, sewing, riding in the cars, etc.
The headache is usually over the region of the temples
or just above the eyes, but it may be on the top of the
head or at the base of the skull.

Vision is so fundamentally related to all the brain func-
tions that eye-strain, or anything which interferes with
normal sight, may cause the most varied disturbances
of bodily functions.

The Prevention of Eye-strain. — Persons whose work
necessitates much ocular labor should vary their duties
with intervals of rest. In continued reading or sewing
it is well to desist at short intervals and fix the gaze on some
distant object, and to frequently close the lids.

Lace work, very fine needle work, working on black
goods, reading very fine print, or print on an inferior
quality of paper, or attempting to read in a dim light, are
all a severe tax on the eyes, and should be avoided,
as they are certain to cause them permanent injury.

Defective vision is so common in school-children, it is
BO often present without being suspected, and so much
harm is done to the eyes and the general health of the
individual before it is discovered, that there should be
a compulsory law requiring the examination of all school-
children; and, again, before boys and girls enter the
normal schools and colleges.

Clear vision gives clear judgment; defective vision in its
various manifestations gives different warps and bents
to the mind of their unfortunate possessors.

Veils. — The wearing of veils is responsible for not a
little deterioration of vision, particularly when they are
thick or dotted. Unless the meshes of the veil are very
large, it holds a layer of impure air close to the face, so
that the wearer is breathing vitiated air. It hinders
clearness of vision, because the external world is viewed
through a narrow lattice.

The best veil for the eyes is one with a single mesh,
either without dots, or the dots so far apart that none
shall come over the eyes.

NERVOUS SYSTEM BALANCE OF POWER IN BODY 211

Protection of the Eyes from the Glare of the Sun. — In very
hot weather the eyes should always be so protected that
the rays of the sun do not shine directly into them. This
protection may be afforded by the brim of the hat or by a
parasol. At the sea-shore, or on an ocean voyage, where
the glare of the sun is constant and particularly trying,
the eyes should be protected by wearing slightly tinted
smoked glasses.

Artificial Lighting. — The main sources of artificial
lighting are kerosene, gas, and electricity. The principal
questions of importance are the quantity and quality of
the light, its steadiness, the vitiation of the atmosphere
by the products of combustion, and the expense; also the
proper arrangement of the light.

Kerosene is the most extensively used means for arti-
ficial lighting. The principal objections are — the heat,
the trouble of filling and keeping the lamps in order, and
the danger of explosion and fire if upset; the odor and
the great vitiation of the atmosphere.

The modern lamp gives a brilliant light, and if prop-
erly shaded by a slightly bluish chimney, so as to absorb
the excess of yellow rays, it is very satisfactory.

Illuminating gas, as furnished in cities, has a great
excess of yellow rays, which are very injurious to the eyes,
and the vitiation of the atmosphere is very considerable.
Gas-light is modified by the Argand and Bunsen burners.
Of these, the Bunsen burner, a patented composition
burner, heated to incandescence, is the best. It gives a
white light, resembling daylight, and, under proper adjust-
ment, a far greater volume than any other burner. It is
not so hot, does not consume as much gas, and so there is
less vitiation of the atmosphere. It is intensely brilliant,
and must be shaded by ground glass or a proper shade.

Electricity gives the very best light, with a minimum
amount of heat and vitiation of the atmosphere. For
individual use 16-candle power is sufficient.

The lamp-shade should be opaque, of a dark-green color,
and lined with a white, reflecting surface. Transparent

212 PERSONAL HYGIENE FOR WOMEN

lamp-shades, especially when patterned, are always bad,
whatever their color; because of the different degree of
illumination thrown upon the work, the light is irritating
to the eyes.

Hygienic Precautions in Reading and Sewing. —
There should be free access of open daylight. Near the
window is obviously the best place for working, and the
seat should be so selected that the window is to the left of
the worker. This prevents the work from being shaded
by the hand, and protects the eyes from being fatigued
by the light falling directly into them.

Any room will have too much light into which the sun
shines directly. Even if the worker's face is not turned
directly toward the sun, yet the light reflected from the
book or other work will be so intense as to be dazzling.
The softest and most pleasant light to work by is the
diffused light from the northern sky. An excess of
light may be easily regulated by a shade.

Reading. — -Very fine type should always be avoided,
it is a very unnecessary strain on the eyes, as are also
books printed on a poor quality of paper with improper
spacing. The paper should be unglazed.

Length of Dine. — The length of the printed line should
not be more than 4 inches, nor less than 2£ inches; that
is, not more than 10 or less than 7 centimeters. If the
line is too long, the effort to find the succeeding h'ne is
too great. If, on the other hand, the line is too short,
the lateral movements of the eye are so frequent that the
muscles concerned in these movements soon become
fatigued.

The position of the reader should be sitting upright,
with the back toward the light, which should fall over the
left shoulder, and the book held nearly on a level with
the eyes. The book should be held at a distance of about
12 inches from the eyes. The light should be on a level
with the head or slightly above it. In desk work, a shade
should always be worn to protect the eyes.

Reading in the recumbent position is a pernicious habit,

NERVOUS SYSTEM BALANCE OF POWER IN BODY 213

and is particularly bad when convalescing from an illness
or when very tired.

Reading in carriages or cars is injurious to all eyes,
but especially so to myopic eyes; because of the constant
jolting, the distance between the type and the eyes is
continually changing, necessitating the frequent and
abrupt adjustments of accommodation; besides, the
illumination is apt to be very poor. Reading in a dim
light or the twilight is also very bad for the eyes.

Sewing and embroidery require the most trying ocular
labor and the best conditions for illumination. Working
on black goods by artificial light should be absolutely
forbidden.

Injuries to the Eyes. — The most common injuries to
the eyes are the entrance of small particles of dust, cinders,
steel filings, etc., into the conjunctival sac, or into the
substance of the cornea. Frequently, with the aid of a
little winking, the tears wash away these foreign sub-
stances, but if the susbtance lodges in the lining mem-
brane of the upper or lower lid, or is imbedded in the
cornea, it may be necessary to resort to other means in
order to remove them.

The lining membrane of the lower lid is brought into
view by simple tension of the lower lid downward by one
finger. If the offending particle is not seen, the upper
lid should be everted. This may be easily effected by the
fingers alone. The patient is told to look down, the
edge of the upper lid and the lashes are seized by the
thumb and forefinger of the right hand, and the lid is
drawn at first forward and then downward away from the
eye, then upward over the point of the thumb or fore-
finger of the left hand, which is held stationary on the
lid and acts as a fulcrum. The foreign body should be
removed with the handkerchief, but, if it is imbedded, it
may be necessary for a competent physician to remove it.

The habit of opening the eyes when dipping the face
into a basin of water, or when diving, produces congestion
and inflammation of the conjunctiva.

214 PERSONAL HYGIENE FOR WOMEN

Symptoms and Treatment of Conjunctivitis. — The

eyes may be blood-shot and the lining membranes of the
lids intensely red. There is a sense of irritation about
the eyes and an intolerance of light, with a constant sense
of discomfort. The sensation produced is that of having
sand in the eyes. The eyes are heavy, and tire after using
them for a short time.

The best treatment for acute conjunctivitis, which is
so often caused by the penetration of dust or other foreign
bodies into the conjunctival sac, is the application of
cold water. A folded handkerchief is wrung out of ice-
water and laid on the closed lids. It must be changed
every few minutes, so that it shall not become warm;
two cloths are necessary. When the acute symptoms
have begun to abate, the patient will no longer find these
applications grateful, and they must be discontinued.

For chronic conjunctivitis hot applications are the best.
For these, one teaspoonful of fine table salt may be dis-
solved in a pint of hot water, or two teaspoonfuls of boric
acid may be used instead; the last named is a mild anti-
septic. The boric acid dissolves very slowly, so that it is
well to prepare enough in the morning for the entire day.
One tablespoonful of boric acid may be put into a quart
bottle of hot water, and be well shaken from time to time,
until there is a perfect solution.

When ready for use, half a pint may be heated, poured
into a tumbler, which is then placed in a basin of hot
water; this latter serves as a water-bath to keep the
solution in the glass hot. The application should be made
with a rather thick wad of absorbent cotton or a piece of
fine cheese-cloth. The absorbent cotton should be picked
up with all the water it will hold, and be placed over the
closed eyes just as hot as can comfortably be borne, and
held there until it begins to cool, when the procedure
should be repeated. The two eyes can be treated simul-
taneously. These hot fomentations should be kept up
for ten minutes, and be repeated four times a day.

Trachoma. — This malady, of which so much is heard

NERVOUS SYSTEM BALANCE OP POWER IN BODY 215

now, is another name for granular conjunctivitis or
granular lids. The affection is very contagious. It
comes on slowly, and is frequently accompanied by redness
and an appreciable degree of secretion in the early stages.
Presence of secretion or of interference of the vision
should always attract attention.

Strict precautions must be taken that the patient's
handkerchief, towel, and wash-basin are not used by other
members of the family. Further, the other members of
the family should bathe their eyes several times a day with
a solution of boric acid.

Styes. — Styes are a very painful species of small boils
that generally form on the edges of the eyelids. They are
apt to appear in succession. Certain persons are liable
to them if the system is run down from general causes.
Like boils in other parts of the body, they give evidence
of impaired nutrition.

Hot fomentations of boric acid solution will some-
times abort them if used early. If pus haa formed,
the stye must be opened by an incision parallel to the edge
of the lid. This should not be attempted by any one
except a physician.

Color-blindness. — As a rule, about 4 per cent, of males
and about one-half of 1 per cent, of females are color-blind.
The part of the color sense that is most often deficient
is that for green and red.

Cataract. — This is a disease in which the crystalline
lens or its capsule, or both, lose their transparency and
become opaque. Eventually total blindness is the result.
Senile cataracts appear after the forty-eighth year. The
only remedy for the disease is the surgeon's knife.

Functional Nervous Disorders. — Evidences of sound
health are: first, individual adaptability or capacity of
the individual to easily adapt herself to extremely oppo-
site conditions of existence; second, endurance, or the
capacity to do a considerable amount of mental work for
a short time without suffering fatigue, or to be able to
quickly recover from the fatigue; third, to be able to

216 PERSONAL HYGIENE FOR WOMEN

control the emotions; fourth, to be able to resist morbific
influence; that is, the capacity on the part of sound
organs of excretion to quickly eliminate all poisons from
the system.

The signs of debility are just the reverse: first, de-
formity, obesity, or leanness; second, personal inadapta-
bility, that is, when physical or mental discomfort is
caused by such slight provocations as change of food,
clothing, or climate; third, lack of endurance, so that a
long rest is required to repair the fatigue incident to
slight exertion; fourth, lack of control of the emotions;
fifth, a proclivity to morbific influences, so that the
individual succumbs to every contagion or miasm that
she encounters.

Nervousness is a disease of civilization, coupled with
overwork and indoor life. The more complex the environ-
ment in which the individual finds herself, and to which
she must adjust herself, the greater the demands made on
the nervous system.

The extreme dryness of our climate, together with the
great variations of temperature between winter and sum-
mer and the rapid fluctuations of temperature, predisposes
to nervous disorders.

Headache. — Headache is a symptom rather than a
disease, but there is no symptom which requires more
careful investigation of its cause than that of headache.
It occurs at all ages, but is most common from ten to
twenty-five years and from thirty-five to forty-five years.
Women suffer from headache more than men, in the
proportion of about three to one. Headaches are most
common in the spring and fall of the year and in the
temperate climates.

Causes of Headache. — These may be classified into those
in which the blood is at fault; reflex causes; various
nervous disorders; and organic diseases.

The blood may be impoverished, as in the case of anemia,
where there is a deficiency in hemoglobin ; but by far the
most frequent cause of headache is where the blood is

NERVOUS SYSTEM BALANCE OP POWER IN BODY 217

disordered, as in gout, rheumatism, kidney diseases,
diabetes, and the infectious fevers and malaria.

Among the more common reflex causes are eye-strain,
especially errors of refraction; disorders of digestion,
particularly constipation; and pelvic disorders, as in
inflammation of the pelvic viscera.

Functional diseases of the nervous system causing head-
ache are overwork, neurasthenia, hysteria, epilepsy, and
neuritis.

Among the most common of the organic diseases is
arteriosclerosis; other diseases are meningitis and brain
tumors.

Symptoms. — The pain is often dull in character and
rendered worse by stooping; the location of the pain
depends on the cause of the headache. The most common
variety is over the forehead or eyes. In eye-strain the
pain may either be in the front or back of the head.
In indigestion, the pain is most frequently over the eyes,
but it may also be on the top of the head. In anemia
the pain may be either frontal or diffuse. In pelvic dis-
orders the pain is generally at the base of the brain,
though it is sometimes in the top of the head.

Neuralgic headaches are generally characterized by
sharp paroxysmal attacks, located in the temporal regions,
and associated with pain in other parts of the body. It
is perhaps most frequently caused by anemia.

In hysteria the headaches are characterized by a
circumscribed pain — it has been likened to the driving
of a nail into the head.

In migraine the pain is paroxysmal and intensely
severe; it is frequently caused by some poison in the
blood, as in autointoxication, due to failure of proper
regulation of the bowels, also by pelvic disorders.

Treatment. — The treatment is constitutional, and is
based on the removal of the cause. First, there should
be a regulation of the diet, a free evacuation of the bowels,
and their proper regulation. In every case of headache
there should be an examination of the urine. Often there

218 PERSONAL HYGIENE FOR WOMEN

is some congestion of the kidneys where it is least sus-
pected. If the headache is persistently made worse by
reading or sewing, the patient should be referred to a
competent oculist. An inquiry should always be made
into the condition of the menstrual function, backache,
and leukorrhea. Any marked disorders here will neces-
sitate a gynecologic examination.

For the immediate relief of migraine, the patient should
go at once to bed and drink a glass of hot water; some-
times a cup of hot tea gives great relief. No food should
be taken for from six to twelve hours, according to the
severity of the case. The room must be kept dark and
quiet and the head high.

A strip of prepared mustard leaf, 5 inches wide by 8
inches long, should be cut, and a piece of cheese-cloth, 6
or 8 layers thick, should be folded the same size. The
cheese-cloth is then wrung out of hot water, and the
mustard leaf is quickly dipped into the same. The cheese-
cloth is placed on the back of the neck, between it and
the mustard leaf. The clothes should be kept dry by
a folded napkin. In this way the mustard may be kept
on from six to eight minutes, until it begins to burn
and the skin get red. If left on too long, the mustard
may produce the most painful kind of a blister. When
taken off the neck, the mustard may be put on over the
stomach.

The medicinal treatment must be directed by the physi-
cian, but a perfectly safe prescription, and one which may
be kept on hand, is the following; Take of sodium bromid,
15 grains; of essence of peppermint, 10 drops; and of
water a sufficient quantity to make 1 dram. Mix well.
The dose may be repeated in three hours if necessary.
This prescription should be put up by a good druggist, in
a three-ounce quantity. Sometimes relief is afforded by
1 teaspoonful of the aromatic spirits of ammonia, taken
in four tablespoonfuls of water, and this is about the right
quantity of water to take any liquid medicine in. At
night 2 grains of calomel should be taken, so Jhat the

NERVOUS SYSTEM BALANCE OF POWER IN BODY 219'

patient shall not be disturbed through the night, and it is
not so apt to cause nausea as when taken through the
day.

Neurasthenia or Nervous Prostration. — This disease
first saw light in the United States, and was christened by
Beard as an American disease that was absent from no
household in which the inhabitants used their brains.
It is certainly much more prevalent in this than in any
other country. Americans scarcely treat their bodies
with more consideration than their automobiles; they put
on high pressure and speed them to the utmost. Add to
the high pressure under which we live that other fact of
heredity, that many persons are born with unstable nerve-
cells, and may be nervously bankrupt, and it is not difficult
to understand that 50 per cent, of Americans are suffering
in some degree from lowered nerve tone.

Causes of Neurasthenia. — All classes of men and women
who use their brains severely, and who have seasons of
excessive anxiety and responsibility, are subject to
neurasthenia. We have seen that fatigue was caused
by the accumulations of toxins in the body, due to muscular
activity, but these toxins may also be caused by intel-
lectual overwork or anxiety over domestic or business
affairs.

Other causes are the intemperate amount of intellectual
work which is forced on the brain, and the excessive
indulgence of the emotions and the passions. Combined
with the strenuousness of life is the large element of
uncertainty, the intense anxiety, and the restless en-
ergy which is the price of success. Added to these may
be lack of suitable and sufficient recreation and short
hours of restless sleep; the restrictions of a narrow lot,
loneliness, and isolation, the frequent- repetitions of un-
interesting tasks, added to the burdens of maternity,
domestic cares, and worries.

In cities the ear-strain caused by the incessant noises
of the street, the amount of work done by insufficient
and improper lighting, the unsanitary mode of life, the

220 PERSONAL HYGIENE FOR WOMEN

improper diet, the monotonous and infertile work, the
unhappiness and discontent bred of a life of idleness, or
one given to society and gambling, whether bridge whist
or poker, the senseless bolstering of shattered nerves with
alcoholic stimulants and beverages, patent medicines, and
hypnotics, all add their quota to the breaking down of the
nervous system.

A man can do a prodigious amount of work if he only
varies it with play which really amuses him, or if he sub-
stitutes for mental occupation those which involve
bodily exercises.

In so-called latent gout insomnia is a frequent symp-
tom, or insomnia may develop as the result of bad nervous
habits. Insomnia from whatever cause is followed by
the impairment of nerve substance and an overloading
of the body with toxins. This continued nerve exhaus-
tion leads to oxaluria, uric acid, gout, anemia, gastric
and intestinal dyspepsia, muscular insufficiency, and
precordial distress.

Whatever enfeebles the body by overtaxing the nervous
system the waste is in excess of the repair, in all over-
work the destructive metamorphosis is greater than the
reparative processes, and so there is an accumulation of
toxic products and a more or less severe and permanent
injury is done the nervous system.

Other causes of neurasthenia, not so generally recog-
nized as overwork, are to be found in the pathologic con-
ditions of the intestinal canal, which becomes a veritable
culture tube, and absorption from this into the blood con-
stantly takes place. And this condition of putrefaction
has to be overcome before relief can be afforded, and in
many cases this condition is associated with an insuffi-
ciency of the elimination of urine.

The large intestine is the seat of an enormous bacterio-
logic flora; they are not there by millions, but by billions.
Some of them are harmless, but not all of them, and if
these pathogenic bacteria are present in sufficient quan-
tity, they, too, may produce symptoms of mild poisoning.

NERVOUS SYSTEM BALANCE OF POWER IN BODY 221

So, too, may mere indigestion, or the malfunction of any
other organ, torpidity of the liver, a deficiency of the ex-
cretion of bile, which is generally accompanied by con-
stipation.

The Symptoms of Neurasthenia. — The symptoms are
essentially those of chronic fatigue, which has become ex-
aggerated and pathologic. They may be classified as
sensory, motor, psychic, and somatic. The sensory
symptoms first noticed are those of generalized fatigue,
with such localized sensations as headache, backache,
and limbache. The motor symptoms are muscular fa-
tigue, muscular weakness, and muscular exhaustion on
slight exertion. The psychic symptoms are manifested
by a diminution in the capacity for sustained mental
effort and the spontaneity of thought and exhaustion after
slight mental effort. The somatic symptoms show them-
selves in atony of the digestive tract and the circulatory
apparatus, with disturbances of the secretions.

Headache is one of the most common symptoms of
localized fatigue, and, associated with this, may be a
sense of constriction about the head, and there may be
either a sense of lightness or fulness of the head.

A woman who is chronically tired loses all her personal
vigor, force, aggressiveness, and, above all, will power.
Associated with this lack of will power are hesitation, in-
decision, a marked irritability, and timidity. Neuras-
thenic patients are subject to spontaneous attacks of
fear, causeless in origin, and generalized in character.
These attacks may be accompanied by pallor of the face
and palpitation of the heart, just as in normal fear. The
tired woman is a cross woman. The irritability shows
marked impairment of the power of inhibition.

The Rational Treatment of Neurasthenia. — First of all,
there must be a removal of the cause which has produced
it. There are two distinct classes of cases — the over-
worked and the idle. The first class, and the most im-
portant to the world, are the overworked. We may have
to deal with the intellectually overworked, in which the

X

222 PERSONAL HYGIENE FOR WOMEN

mental overwork was combined with financial anxieties,
domestic difficulties, or lack of success in their work, or
the cause may have been the tremendous responsibilities
of their positions, which involved the lives or fortunes of
many people. Added to this great strain and overwork,
has been a lack of proper intervals for rest, recreation,
and sleep, and the body has become a storehouse for vari-
ous toxins, and so is suffering from both acute and chronic
poisoning.

This class of patients must have the most rigid rest
treatment, such as was prescribed by Weir Mitchell years
ago. It is most important that the patient should be
removed from her old surroundings; if this is not possible,
she should be isolated on the top floor of the house with a
good nurse. The room selected must be bright and cheer-
ful, with plenty of sunshine and fresh air; a window should
be open practically all the time, for oxygen and sunshine
are two of the best restoratives. The diet must be easily
digested and very nutritious. The patient should be
urged not to use her mind at all. Carefully selected short
stories may be read aloud by the nurse ; the reading should
not be continued for more than half an hour at a time.

A great deal may be done to eliminate these toxins from
the system by the proper use of electric-light baths, fol-
lowed by the shampoo and the percussion douche; mass-
age with salt water, salt rubs, and electricity.

In most cases a month of this absolute rest is as long as
is beneficial to the patient. And for most of them the
seashore is the best. There should be enough going on to
be diverting without being overtaxing, and a climate
should be selected which is warm enough for the patient
to live out-of-doors. There should be short walks, drives,
sails, etc., and this outdoor life, with a contemplation of
nature, is the most powerful restorative. The grandeur
of nature, whether it is the mighty forests, with their re-
freshing shade and quiet, or even stretched in a hammock
watching the sky and trees, or the constant surging of the
vast sea, bringing rest in its unceasing restlessfless, with

NERVOUS SYSTEM BALANCE OF POWER IN BODY 223

the ships sailing lazily along, until the whole fades away
in the distant horizon. In the vastness of the universe, the
ego becomes contemptibly unimportant and insignificant.

After several months spent in this way the body has
gotten rid of its toxins, nerves and muscles are rested, and
through the soothing influence of nature the neurasthenic
is gradually trained back to a healthier habit of thought
and a more rational frame of mind. There is substituted
for the morbid emotional complex a feeling of pleasure
and energy. Reason and judgment reassert their sway;
outdoor life quickens the perceptions, and forms tranquil-
izing memory pictures on the brain that return later to
solace and refresh the individual.

There is another, and a very large class, of cases among
women of leisure who have suffered all their lives from
a lack of a vocation; they have nothing to think of except
themselves. They do not know what it is to be quite well;
they travel from one part of the country to another, and
from one country to another, but they never rise above a
certain level of invalidism. They are self centered, and
what they need is the work cure. In the majority of
cases, before these patients can be restored to health,
powerful habits must be eradicated, new interests in
others must be supplied to supplant the most intense egot-
ism, new paths must be hewn out in the brain, the will
must be recreated, and character can only be imparted by
those who possess it.

CHAPTER VII

THE HYGIENE OF THE MIND AND ITS RELATION
TO THE PHYSICAL HEALTH

Heredity; Temperament; Social Instincts; Fear.

Mental Development; Self-control, the Moral Sense, the Religious
Instincts; the Advantages of College Life; Balance of the Mental
Faculties; the Effects of the Higher Education of Women.

The Environment; the Choice of Friends; Literature.

The Power of the Will or Inhibition; the Effect of the Mental
Attitude on the Physical Health; A Definite Occupation a Physical
Necessity; the Psychology of Success.

THE solidarity of brain and mind is an axiom of modern
medicine, and it is a fundamental principle that must be
kept constantly in view in all physical and mental training.
Hitherto unsoundness, inefficiency, and weakness of mind
have only been lightly touched upon in preventive medi-
cine, but the importance of the mind as the chief factor in
health and disease is so paramount that it can no longer be
ignored. .

The problems that present themselves to the mother and
the educator to-day are practically the same, and the
mother is one of the most potent educators that we have —
how the mind can best be strengthened, broadened, and
be made the most efficient working instrument possible
through the application of modern scientific and physio-
logic knowledge. These are questions of vital importance
to the human race.

Heredity. — Holmes says: "Each one of us is only the
footing up of a double column of figures that goes back to
the first pair. Every unit tells, and some of them are
plus and some of them are minus. We are mainly nothing
but the answer to a long sum in addition and subtraction.

224

HYGIENE OF MIND AND ITS RELATION TO HEALTH 225

Slight obliquities are what we most have to do with in
education."

There are certain hereditary predispositions that will
develop under certain conditions; some of them are good,
some are evil; that is, with the natural development of the
mind, certain peculiarities of the ancestors will be repro-
duced. The problems suggested are how the mind can
best be developed, educated, and trained, so that heredi-
tary weaknesses may be counteracted or held hi abeyance,
and that latent hereditary talents may be discovered and
developed.

The first proposition that we have to face is that like
produces like. There are modes of education, of conduct
in life, and of occupation that should be avoided where a
boy or girl is handicapped by a bad heredity. There
are special precautions and attention to physiologic laws
which would save the minds of many young men and
women with a bad heredity from passing into a state of
inefficiency and actual disease. Heredity implies only
potentiality toward good or evil, and the latter may be
averted by knowledge and the proper practice.

Temperament. — This comprises the general make up
of the individual, the shape of the head, the appearance
of the eyes, the mobility of the features, the texture of the
hair and skin, and the kind of movement. The recog-
nition of the kind of temperament, and a suitable training
for its best development, is of the greatest importance in
attaining good health and success in life.

There are four general types of temperaments — the
nervous, the phlegmatic, the arthritic, and the scrofulous
or lymphatic.

The nervous temperament has certain marked char-
acteristics, as the small, wiry figure, the well-shaped head,
the bright, restless eye, nervous bearing, highly strung
and sensitive nerves, feeling pain keenly and bearing it
badly. This woman is imaginative, sensitive, fond of
intellectual work, often artistic and ambitious. In her
the brain and mind are dominant above all else. When

15

226 PERSONAL HYGIENE FOR WOMEN

run down, this woman will be difficult to bring up again to
the normal level. She will grow thin, dyspeptic, irritable,
and often neuralgic. She will be peculiarly liable to ner-
vous disorders.

This temperament has its special temptations — alcohol
and sedative drugs are two of them. Alcohol is not taken
steadily or for social reasons, but for the effect of alcohol
on the brain, and there is the greatest danger of becoming
addicted to alcoholic habits, and finally of becoming an
uncontrollable dipsomaniac.

The phlegmatic or bilious temperament relates more to
the training of the body, since in this class of cases the mind
is not exposed to the same dangers, but the oversanguine
temperament has its own dangers, which may lead to lack
of effort, speculation, and financial ruin.

The arthritic have a predisposition to both rheumatism
and gouty disorders, to which they are distinctly more
liable than others, and the fact that there is this latent
tendency should be taken into consideration during child-
hood and youth.

Social Instincts.— Social instincts lie at the foundation
on which the family and community is based. It may
be said that any individual who is destitute of them is in
an abnormal condition, hence a right training of the social
instincts is, beyond doubt, one of the most important means
of securing happiness to the individual and order to society.
The child's or youth's relation to others, her affection for
others, and her altruistic practices, all go for the making
of society, good citizenship, and patriotism in the race.

At the school age the social instincts are one of the
strongest elements in life, and one of the most powerful
adjuncts in developing mind and body. The cravings of
young women for social amenities are stronger, and her
deprivation of them more hurtful, than in the case of
young men. There are few girls in whom it does not re-
quire some regulation. The strain of too much social
life is injurious; social dissipation cannot be combined
with school life without wrecking the health of th§ young

HYGIENE OF MIND AND ITS RELATION TO HEALTH 227

woman; nervousness, anemia, and mental depression
follow.

That individual cannot be said to be healthy mentally
whose social instincts are poor and perverted. Commonly
one of the first symptoms of a disordered mind is the dimi-
nution of the social instinct. The insane are notoriously
asocial.

Fear. — This is one of the most elemental and primitive
of the emotions. Biologists assure us that fear and sur-
prise were the first of the emotions to be developed, and
that the feeling of the ludicrous was the last. Darwin
says that the earthworm knows fear, and darts into its
burrow like a rabbit when alarmed. So we see that fear
is common to all forms of animal existence, even to th§
lowest. This universality of fear has come about through
the working of the laws of natural selection, which pre-
scribe that only those creatures shall survive that can
best adjust themselves to their environment. Within
limits, fear as a primary instinct has been and is eminently
useful. It is the cry of alarm raised by the senses which
act as guardians of the body, and, at a signal, in virtue of
the nervous automatism, the organism is put in a position
of defense. On the other hand, fear may serve to paralyze,
as has been observed in the case of birds, many of which,
though scarcely wounded by the small shot, fall to the
ground as if struck by lightning, panting with wide-open
eyes. In human life, while fear incites to activity, it may
also paralyze that activity.

Mosso says that the fear that young children have of
cats and dogs, before they have learned why they are to
be feared, is a consequence of heredity. We are born to a
heritage of fear. If we fear ghosts and demons less, we
fear microbes and bacteria more. The professional or
business man fears failure, but fear should be a guardian,
not a jailer. A healthy fear of indigence will lead to thrift,
industry, and such measures as will secure one's personal
independence. Up to a certain point, fear is a protection,
but beyond that it paralyzes.

228 PERSONAL HYGIENE FOR WOMEN

Mental Development. — We note that at birth the
brain is mindless, and that the brain-cells, which are the
vehicle of the mind, undergo their greatest development
during childhood from stimuli coming from without the
body. The brain-cells possess infinite possibilities and
potentialities. They are developed from the stimuli from
without through the eyes, ears, touch, taste, and smell.
There is another series of constant impressions which are
received from within the body, and these come from the
muscles.

These impressions, conveyed to the brain-cells from the
body, and from the outer world beyond the body, leave
a fixed registration, the writing on the brain-cells has
begun, and this constitutes memory; and the imprint on
these cells is similar to that which type leaves of letters
and words on the page of the printed book. These printed
impressions on the cells can be revived and seen and heard
by the mental consciousness, just as a printed book can be
opened and seen and read by its owner.

The natural qualities of the mind are imitation, acquisit-
iveness, emotionalism, and imagination.

The force of example in the home, at school, and in the
book world is among the most potent influences' in
molding character. The young girl instinctively imi-
tates her mother, her friends in real life, and in her book
world, and the woman will be the composite production,
combining traits of all of these, which will be ingrafted on
the ancestral traits which have been inherited.

In young children it is difficult to decide where the
imagination leaves off and the spirit of untruthfulness
begins. In any case, the tendency to exaggeration and
untruthfulness are so prevalent in childhood that it must
be checked at the earliest signs of its appearance. The
vice becomes so deep rooted that it affects the mind in all
its workings and the entire life as well. It follows men and
women into their business careers, their scientific life, and
their professions.

Professor Swift, in a very interesting study of the devel-

HYGIENE OF MIND AND ITS RELATION TO HEALTH 229

opment of the mind, invokes the aid of biology to show that
all children are but little animals, having no inborn notions
of right and wrong, inheriting no sense of justice; savage,
by nature, and predatory by instinct.

He finds a psychic justification for fighting among
boys. "Fighting in some form," he says, "is one of the
first means by which the mind becomes accustomed to
intense action. To fight well, a boy must be capable of
severe concentration of attention."

And he has found the age at which boys come to think
that laws and the recognized rules of right conduct should
be voluntarily respected varies from fifteen to seventeen
years and older. These figures are approximately correct
for girls.

Absolute truthfulness, square dealing, honesty, honor,
and an esprit de corps should be demanded. Hitherto
these principles have not been sufficiently inculcated in
girls as the fundamental principles on which life must be
met. The discipline has been too lax in the home and in
the school; it is that of implicit and prompt obedience on
the word of command; the proper subjection to and res-
pect for those placed in authority; the kind of discipline
given in business life, the hospital, and the army, and the
lack of which has cost so much happiness and so many
thousands of lives.

Self-control. — The perfect capacity for self-control in
all directions and at all times is the ideal state at which we
aim. It is the standard aimed at by developing the power
of the will and the strength of inhibition. The great diffi-
culties, the magnitude of the task, may be conceived of
from the saying of the wisest of all men : " He who conquers
his own spirit is greater than he who taketh a city." The
reason is plainly evident — all the hardest battles of life
must be fought out alone, there is a feeling of isolation, as
if one were struggling alone against the combined forcea
of the universe, and, at the same time, there is going on
the struggle for the mastery between the two conflicting
natures, " When I would do good, evil is present with me."

230 PERSONAL HYGIENE FOR WOMEN

Whereas, in concerted action there is a feeling of sympathy,
of reinforcement from outside help, and the pleasant stim-
ulation of competition.

If youth were taught that certain enemies were going
to present themselves on the field, that they come for the
most part in the first instance single handed, and if grappled
with one at a time, and the contest between right, and
perhaps inclination, be then and there fought to a finish,
each successive time the conflict would be easier and the
victory more certain ; that in losing such a battle there
must always be a certain loss of self-respect, a feeling of
moral weakness, it may be even so slight a fault as the
exaggeration of facts; while, on the other hand, a victory
always gives something of the same feeling of exultation
that one has in any fairly won contest or game. A feeling
of pleasurable superiority, of having one's self well in hand.
In the moral habits every gain on the wrong side undoes
the effects of many conquests on the right. The training
of the will becomes the most vital of all problems. Noth-
ing that is learned in youth is really so valuable as the
power and habit of self-restraint, of self-sacrifice, of ener-
getic, continuous, and concentrated effort.

The Moral Sense. — From fifteen to twenty-five years of
age is the most crucial period of life in regard to the hygiene
of the mind. It is during this period that the brain
first exhibits some of its strongest hereditary tendencies.
While such mental factors in human life as conduct and
character are being consolidated, as they now are, heredi-
tary predispositions manifest themselves, telling for good
or evil, for success or failure.

The acquisitions then made are critical in the extreme
and often final. The real love of right, hatred of wrong,
duty, conscience, religion, become solid and effective in
forming character.

The emotional nature instinctively shows a leaning
toward the opposite sex ; love between the sexes toward the
close of adolescence is the most intense and most unreason-
ing of human passions. The sense of right, wrong, and

HYGIENE OF MIND AND ITS RELATION TO HEALTH 231

duty become active principles, dominating the character,
There are yearnings after the ideal, an intense scorn of and
hatred of evil. The purposes in life are then shaped.
The impressions and resolutions then formed affect the
whole tenor of the woman's Life, as a rule, more than at
any other time.

The capacity to feel pleasure reaches its greatest inten-
sity. The sex relations are built up on safe and natural
lines, regulated by family life, social feelings, and the carry-
ing of the thoughts and the emotions into other channels,
controlled by certain instinctive natural tendencies, by
morality and religion. To think and feel properly should
mean to act rightly as a physiologic corollary.

Music, literature, and art, imaginative works of all
sorts, mix themselves up with the sex feeling, so that the
two help to form the emotional nature. Far-away glimpses
of poetic feeling, pleasurable altruism, citizenship, and
patriotism show themselves in the earlier stages and give
direction to life in the later. The whole period is one of
immense importance for the health and happiness of the
remainder of life, and the risks to the body and mind are
then very great. A fact which is of great importance, and
which is especially true of adolescence, is that it is possible
by undue pressure to use up stores of energy that should
have been spread out over very long periods. Through
such overexertion in study or in games too heavy a drain
is made on futurity, and mental disorders at this time are
by no means infrequent, mental depression being generally
the first to appear. This is more especially true in the
descendants of neurotic families. The subjects are troubled
with neuralgias, insomnias, and there is a pessimistic view
taken of life.

The Religious Instincts. — Mobius says, "We reckon the
downfall of religion as one of the causes of mental and
nervous diseases. Religion is essentially a comforter.
It builds for the man, who stands amid the evil and misery
of the world, another and fairer world. Besides his daily
careful life, it lets him lead a second and purer life. The

232 PERSONAL HYGIENE FOR WOMEN

consciousness of being within the hand of Providence, and
the confident hope of a future redemption, is a support to
the believer in his work and care, for which unbelief has
no compensation. Meditation calms and refreshes him
like a healing bath. Worship breaks in upon the daily
drudgery of his days with rest and meeting." The moral-
ity of a nation suffers most severely through the downfall
of its religion, as experience Ijtas always and everywhere
proved.

The religious instinct has a very close relation to the
emotions, morals, esthetic feeh'ngs, to social instinct, and
to sex. The feelings of reverence and awe, and the con-
sciousness of the infinite in man are vague, but are the
most powerful parts of his nature.

Religion furnishes the only pure ideals that half of the
world has access to. It has proved an intellectual stimu-
lus, and roused a metaphysical frame of mind in some of
the most vigorous nations, such as the German and Scotch.
It leads more toward refinement of life than any other
agency. It stimulates the benevolent and altruistic feel-
ings, and leads to their practical demonstrations; it fights
vice and immorality; it seizes on the best that is in man
and transforms the character.

The Advantages of College Life. — College life is of
the greatest possible advantage to girls in many ways:
it is broadening to the mind; discipline is maintained, and,
at the same time, the girl is thrown on her own resources;
adequate means are provided for developing both mind and
body to their greatest capacity.

Whether the girl comes from the country, a country
town or city, her social group is comparatively limited ; her
world is very little and the ego is very large. The dis-
cipline that any large body of students bring to bear
on the conduct and behavior of the individual is one of
the important advantages of a college training. The
insignificance of the ego, who is only a unit in this
large community, is quickly impressed on the gray matter
of the brain, and the rough and unpleasant angles ane soon

HYGIENE OF MIND AND ITS RELATION TO HEALTH 233

smoothed off. This, in addition to the discipline afforded
by the college officers, and the total lack of discipline is
the weakest point in the average girl's education. To
be brought into intimate relation with the members of a
large and educated community is in itself a liberal educa-
tion. To learn to respect the rights and the opinions of
others, to perceive that any given subject has a great num-
ber of points of view, is attaining toward a healthy mental
balance that will make the woman broader minded, more
sympathetic, more companionable, and more charitable
in her views of life.

In addition to the regular college curriculum are the
opportunities afforded, not only to special students, but
to the entire body of students, for a liberal education in
music and art, and so a broad foundation for general
culture is laid that will greatly increase the opportunities
for pleasure all through life.

So that, in addition to the actual knowledge acquired
by a college education, there are also the advantages of
the discipline of and development of mind and body; the
knowledge of how and what is worth while to study; the
power to study and solve life's greatest problems for her-
self and those dependent on her; the firm muscles, the
clear brain, the steady nerves, the power of judgment, the
control of the will, and the formation of character — on all
of which the ultimate happiness and success in life depend.

Dr. Beard gives to brain workers a value of life of four-
teen years above the average. The brain-working classes
are less apt to worry, less apprehensive of indefinite evils,
and less disposed to magnify minute trials than those who
live by the labor of their hands.

Spinoza says that every advance toward perfection
gives us happiness, and it is safe to say that the buoyancy
which characterizes contemporary thought, the hopeful
outlook amidst the dangers which threaten us, the sense
of the added cubit to the man's stature, are due largely to
the recognition of the power for good within his soul of
which he was not formerly aware.

234 PERSONAL HYGIENE FOR WOMEN

Balance of the Mental Faculties. — There must exist a
certain balance between the various faculties of the brain
in order to insure sanity. A high order of intelligence
without much will, or keen emotions without a corres-
ponding power of inhibition, and overmastering will and
slight moral sense, vivid imagination without common
sense, intense social instinct without much conscience,
fervid religious instinct without much sense of duty or
altruism, must invariably produce one-sided and unbal-
anced individuals, and the results would be bad for society;
and too many of these one-sided or unbalanced people
would impair if not endanger the safety of the State.

Excessive ambition, misdirected energy, longing for the
unattainable, regret for the unalterable, anticipation of
future unhappiness, lack of a sense of perspective, fretting
over non-essentials, indecision, reopening of troublesome
questions already settled, avarice, selfishness, excessive
emotions, uncontrolled passions, and the actual cultiva-
tion of the melancholic state are some of the causes of
mental anguish and subsequent physical suffering.

Well-balanced mental faculties give a philosophic view
of life; guard the mental and hold the emotional in check;
grasp the true relationships in life, and view it in the
proper perspective.

The Effect of the Higher Education of Women. — Nothing
is so convincing as actual experience and statistics;1 and
nothing is so broadening to the mind as the study of
history.

Never before in the history of the human race has any .
such large body of young women been given the edu-
cational advantages for the development of body and
mind which they enjoy to-day. From antiquity there
have been exceptional women, who were highly educated
and cultured, as in Alexandria, Athens, and in the old
European universities, but up to the present day any
tendency toward the education of the masses of women

1 " Education as the Controlling Factor in the Physical Life of
Woman," Four Epochs of Woman's Life.

HYGIENE OF MIND AND ITS RELATION TO HEALTH 235

has been looked at askance, and in this respect the position
of the people of the United States was long peculiarly
provincial.

To two men belong the great credit and honor of con-
ceiving the idea of a liberal college education, and a medi-
cal college training, for women in this country.

In 1865 Mathew Vassar, "having recognized in woman
the same intellectual constitution as in man," founded a
college for women only, and thus gave women the oppor-
tunity for the same education that young men enjoyed at
their colleges.

In 1850 the Woman's Medical College of Pennsylvania
was incorporated. The idea of establishing a college for
the medical education of women originated with Dr.
Bartholomew Fussel, of Chester County. The query arose
in his mind, " Why should women not have the same
opportunities in life as men?"

Just how strong the public sentiment was against these
movements, and the leaders of the opposition comprised
the most prominent educators and physicians of the day,
and what impediments they placed in the way, it is now
difficult to realize.

The opponents of the higher education of women urged
three final objections: First, women were mentally in-
capable of receiving the same kind of intellectual educa-
tion as was given to young men at college. Second, they
lacked the physical endurance to bear the strain of mental
work. And, third, such an education would render the
young woman masculine — she would no longer be willing
to look after the ways of her house, her natural affections
and power to love would vanish, she would become unwil-
ling to marry and bear children.

Ex-President Eliot, of Harvard University, who has so
long been the great educational leader in this country,
in his paper on "The Higher Education of Women,"
says: "During tho past thirty-five years three distinct
apprehensions concerning the effect of the higher educa-
tion of women seem to me to have been removed. In the

236 PERSONAL HYGIENE FOR WOMEN

first place, there was a perfectly sincere doubt (because
there was little experience to go upon) whether young
women were so capable as young men of receiving what
was then called the higher education; or, in other words,
whether the young woman had the capacity to master by
study the traditional subjects of the higher education.
That doubt has been completely removed.

"Secondly, it was feared that if the young women
studied in the colleges three or four years, beginning
at about eighteen years of age, that such study would
have serious effect on their health and on their fitness
for their natural functions in after-life. This apprehen-
sion was felt by many physicians and was warmly ex-
pressed. For a whole generation we have been trying
the experiment, and the result is perfectly clear. These
apprehensions have not been justified. It is apparent
that young women can do much mental work for three
or four years between the age of eighteen and twenty-
two, not only without impairing their physical vigor,
but all the time improving it, if they live wisely and under
right conditions.

"And thirdly, there was the strong apprehension felt
by many excellent people, lest in the process of the
higher education young women would be denatured.
They admitted that young men were not denatured in
any way by the higher education at college, but they
thought that there was a serious chance that young women
would be altered in their feminine nature by the process
of education. It has turned out that a young woman
who studies in college, from the age of eighteen to twenty-
two, is no more altered in her nature than a young man is
who goes through a similar process. It takes a great deal
more than that to alter the nature of a woman.

"I suppose that this apprehension was based on the
fact that women seem, to men at least, more tender,
fragile, and delicate than men, and, therefore, more liable
to be bruised or coarsened than men; it was feared that
the kind of public life, so to speak, in large groups would

HYGIENE OF MIND AND ITS RELATION TO HEALTH 237

have some tendency to deprive them of their natural
delicacy, refinement, and tenderness. It has not turned
out so, and everybody recognizes that it has not turned
out so."

When higher education, the professions, and industrial
pursuits are all unquestioningly thrown open to women,
then it can be reasonably supposed that they will come
to possess those traits of mind — judicial, logical, creative,
etc., now generally considered as masculine traits, and
they will not only be more attractive and companionable
for their husbands, but will be far more competent
teachers for their children, their enlarged range of thought
and vision inspiring greater confidence in their sons,
and stimulating higher ideals in both sons and daughters.

The Environment. — As we have seen, the brain
registers every impression from within and from without;
if the impressions are those of discomfort, gloom, darkness,
ugliness, those things, being inharmonious to the con-
stitutional working of the brain, do harm and tend to set
up bad habits. First, the body must be healthy, and
the environment good in order to insure a healthy, vigorous
mentality. Too much thought and care cannot be given
to the environment of the child, youth, and adult.

Careful attention must be given to the toilet. The
quality and condition of the underlinen, the cut and fit
of the clothes, all tell on the mind. It has been said that
a man tries to live up to his clothes; hence, the uniform
of the soldier and the cassock of the priest. Clothes are
not only an index of the character, but they help to make
it. The clothing that comes into intimate contact with
our bodies has a soothing or irritating effect upon the
mind. It has also been said that for a woman to know
that she was properly dressed had a soothing influence
on the mind, second only to that of religion itself.

In the evening, laying aside the business suit of the
day with all the anxieties and dust of toil, and replacing
it by a tasteful house-gown, brings a sense of freshness
that brightens the mind and stimulates the appetite.

238 PERSONAL HYGIENE FOR WOMEN

The clothing should always be suitable to the employment,
to the purse, and to the surroundings, or good taste is
violated, and, again there is an unhealthy reaction on the
mind.

To live in a gloomy house, with a dull ugly wall-papers,
and no sunshine entering the room, may produce in their
inhabitants want of appetite, interfere with nutrition,
make them gloomy, unhappy, and hard to live with.
While esthetic surroundings render life happier, brighter,
and higher.

If one cannot afford expensive paintings to hang on her
walls, she can select photographs of the old masters,
neatly framed, which, placed in harmonious surroundings,
elevate the mind, cause a love of the beautiful, develop
the taste, and lay the foundation for a broad culture
that will increase the enjoyment of nature as well as of
art.

The Choice of Friends. — We have seen that the impres-
sions conveyed to the brain-cells leave a fixed registration
and are indelibly stamped there. These may be called
the sensitive plates of the mind, and it is because of this
writing on the brain that the selection of our friends and
associates is a matter of such vital importance.

The subconscious mind, of which we hear so much to-
day, does not originate thought; it can only elaborate
and develop it, and the most important fact which has
as yet been discovered in regard to the subconscious mind
is that it is suggestible; that is, it is subject to moral
influence and direction. A few words of commendation
and praise brighten the whole day; if we can forget our
pain for a little while, it is apt to cease.

All our greatest intellectual leaders, from time immem-
orial, have been unanimous in their teachings that one
of the most important elements in the molding of the
mind and character was the nature of our friendships.
Tennyson says, " I am a part of all that I have met." "A
man's friendships shape his life more than aught else, or
more than all else." The immortal bard puts* it, "It

HYGIENE OF MIND AND ITS RELATION TO HEALTH 239

is certain that either wise bearing or ignorant carriage is
caught, as men take disease of one another; therefore,
let men take heed of their company." And again, " 'T is
meet that noble minds keep ever with their like, for who
so firm that cannot be seduced?"

Certain requirements and standards should be met,
and the girl or woman should be sure that the individual,
whether man or woman, comes up to the standards of
her own clan.

A friend should be congenial, with similar tastes, oppor-
tunities, and training; frank in criticism, yet sympathetic
in spirit; loyal and staunch in adversity, and one who
disseminates an atmosphere which is broadening, elevat-
ing, and uplifting. Such a friend is to be desired and to
be sought after.

Literature. — Not one of the least of the great molding
influences on the mind and the social life of to-day is its
literature, and the form of this which reaches the greatest
masses of the people are the daily press, the literary
magazines, and the modern novel. It is scarcely pos-
sible for the young to conceive the great impression
which is made on the mind and character by the kind
of books which they read. Carlyle said, " We cannot
look however imperfectly upon a great man without
gaining something from him." And to this statement
might well be added, it is impossible for the mind to be
brought into intimate contact with the lives of dissolute
men and women, so vividly portrayed in many of the
novels of the day, without being smirched by it. It is
no more safe to read such a class of books, hoping to
escape contamination, than it would be to live in the
malarial districts of Africa, and hope to escape contracting
that insidious disease.

However limited the geniuses may be in our immediate
circle of friends, each of us may have for her most intimate
friends the greatest geniuses the world has ever known,
and have them at their best.

Two axioms should always be kept in mind — a real love

240 PERSONAL HYGIENE FOR WOMEN

for books is formed in early life or not at all, and to have
books for friends one must own them, have them on her
own shelves, to take down and put up at will, to mark, to
compare, and study. So whatever else one lacks, she
should always have her own library, even if it is a limited
one.

Next in importance to the recognition of good reading
must necessarily be a recognition of the limitations of one's
reading. Whether hi the capacity of student, housewife,
mother, or business woman, the time that can be devoted
to general literature is very limited.

A careful study of history and biography should always
precede fiction. It is a fundamental part of a liberal edu-
cation to know something of the world's history, and the
history of the English nation, as well as the biographies of
the men and women who were such important factors in
making its various epochs.

This should be followed by a study of the classics, and
that education has not been liberal which has not included
a study of the modern classics. German literature opens
up a new and delightful world. A study of the classics
forms the taste, elevates the mind, broadens the vision and
the power of judgment, and it is a profound help in the
formation of character. After such reading as this, who
would be willing to spend her time on the cheap and trashy
novels of the day.

Good modern fiction should be taken up as a recreation
by the woman whose life is laborious, its questions per-
plexing, and its complications tiresome; in other words,
after the woman has left the high-school or college and has
entered on her life's vocation. For young girls, not only
is too much time apt to be given to fiction which should be
devoted to other and more important matters, but it is
apt to do much harm by giving them a wrong impression
of life.

The Power of the Will or Inhibition. — The conduct of
mankind is chiefly governed by the emotions, instincts,
and impulses. Spencer traces all human action to the

HYGIENE OF MIND AND ITS RELATION TO HEALTH 241

desire for pleasure in the large and philosophic sense of the
term. If this be so, then the education and hygiene of the
emotions and impulses must be of the very highest im-
portance in the life of each individual and in the social
world. The question arises, and it is all important, can
those inhibitory centers be so developed in youth, and so
cultivated in life, that they can act as antagonists to what
is morbid? Can they be used as direct preventive and
curative agencies against tendencies and impulses which
are foolish and hurtful? And the answer of educators, as
the result of large experience and observation, is emphatic-
ally, yes.

But the training, to be efficient, has to be systematic,
persistent, and along well-defined lines. The first step
in this training must be the strict avoidance of all that has
a tendency to lower the standards of morality, whether
this is in the line of companions, literature, the stage, music,
or art. To do otherwise is not brave, but as foolhardy
as it would be for a weak army to advance against a power-
ful foe; it means annihilation or to be taken prisoners
of war.

To overcome obsessions and delusional beliefs by vo-
litional effort, the effort should be made to direct the
mind to other subjects which have nothing whatever to
do with the obsession, rather than to make a direct stand
of the will against it, since the will may put forth its ut-
most strength in the way of direct repression of the
temptation to any immoral action, and may entirely fail,
while, by directing the same amount of force in chang-
ing the direction of thought, complete success may be
attained.

The influence of the will upon the emotions is a matter
of the highest importance in regard to the direction of the
current of thought and the determination of actions.
Control your passions; govern your temper. We can no
more avoid feeling mentally hurt than we can feeling phy-
sical hurt, but we have exactly the same power of the with-
drawal of the attention from the mental hurt as from the

16

242' PERSONAL HYGIENE FOR WOMEN

bodily pain, by determinately fixing it upon some other
object.

"I am, I ought, I can, I will," are, as has been well
said, the only firm foundation-stones upon which we can
base our attempts to climb into a higher sphere of exist-
ence. The first implies a faculty of introspection, the
second a moral judgment, the third a consciousness of
freedom to act, the fourth a determination to exercise that
power.

The influence of the will on the conduct is first auto-
matic, through previously acquired habits; second, through
the emotional state, and third, by our notions of right and
wrong. In the fundamental principles of living must be
included a genuine consideration of the right of others.
The memory is an automatic reproduction of ideas, the
mechanism of recording processes.

The education of the will, the power of breasting the
current of the desires, and doing for long periods of time
what is distasteful and painful, all tend to increase the
power of inhibition and strength of the will. Nothing
that is learned in youth is really so valuable as the power
and habit of self-restraint, of self-sacrifice, of energetic,
continuous, and concentrated effort.

Seneca claims that difficulties strengthen the mind
as labor does the body. Plato said, that "self-conquest
is the greatest of all the victories."

Character lies preeminently in the sphere of the will, and
anything which weakens the will saps the worth of life at
all points. The strength of will bears not only on char-
acter, but on happiness and influence as well. The leader
must show reserved power, and make it plain that she has
herself well in hand, to secure confidence. " Will makes
men giants."

The Effect of Mental Attitude on the Physical
Health. — The ordinary operations of the mind have little
effect on the physical condition, but such emotions as fear,
worry, anxiety, grief, despair, anger, hatred, and the like
depressing emotions act directly upon the muscular and

HYGIENE OF MIND AND ITS RELATION TO HEALTH 243

nervous mechanisms, profoundly affecting the secretions
and the excretions, and stamp themselves upon the very
tissues of the organism.

Of all the mental attributes the emotions are the most
exhausting. A woman can spend more of her strength in
five minutes of unnatural excitement than in a day of calm,
steady brain work.

A perfect temper is not only a prime requisite for a club
president, but for every man and woman in this hard
workaday world, with its fierce competitions, its petty
jealousies, and the stiletto practices of the cowardly,
and it is one of the greatest preventives of indigestion,
insomnia, and nervous prostration.

Forget your grievances. Every time that one repeats
them to herself or to a friend she lives them over again,
and the original trouble was but the merest moiety of
suffering compared to a wound torn open afresh every day.
To cherish a vindictive spirit does a vast amount of injury
to the possessor of that spirit. In view of the facts of
the beneficial effects of fighting upon small boys, and that
the combative propensities of the Irish peasant commonly
evaporates with his shillelagh, it would seem commendable
to introduce boxing matches among women as a way to
settle their differences.

From the standpoint of health, the intense excitement
attendant on playing for high stakes, the loss of sleep, the
unnatural life, the loss of money that one can ill afford to
lose, must eventually lead to a serious if not to a fatal
breakdown.

It is not the natural and reasonable intellectual work
that injures the brain, but the various emotions — ambi-
tion, anxiety, disappointment, the hopes and fears, the
loves and hatreds of our lives — that wear out the nervous
system and endanger the balance of the brain.

Powerful emotion is like concentration attended with
dissociation, it occupies the mind to the exclusion of all
else, even to the dictates of self-preservation and reason.

244 PERSONAL HYGIENE FOR WOMEN

The will is more or less suspended and held in abeyance
during the emotional states.

The too great concentration of the attention on one's
business or occupation is a self-indulgence that often
ignores the importance of the lighter side of life and the
legitimate claims of family and friends.

Less ambition and more philosophy would greatly
lessen the number of cases of nervous prostration and
allied neuroses. All of one's fortune is not staked on one
throw of the dice; if the woman fails in one direction, there
are other resources left.

Concentration of the mind on the physical suffering
leads to the so-called habits in disease; there may have,
in the first place, been a real physical cause. For example,
in case of injury to a limb followed by severe pain in that
member it has happened that after amputation of the
limb the consciousness of pain persisted in the brain.
In the functional neuroses, the first cause may have been
a real physical one, but the individual becomes so self-
centered, it is with difficulty that the mind can be with-
drawn from the ego, and a cure can only be effected by
supplanting the intense egotism by new interests.

Medical literature contains numerous observations of
ailment caused by fright, and even of death itself so
caused. It is not uncommon for medical students to con-
tract the disease about which they are studying. In the
old small-pox epidemics it was a very generally observed
fact that those who feared contracting the disease were
the most apt to get it. The reason is very easily explained
— fear so suppressed the functional activities of circulation
and nutrition, as to predispose the individual to take any
disease to which she was exposed.

Autosuggestion is the predominant element in the con-
centration of the thought on one particular subject, and
of the narrowing of the perspective to a single point of
view.

Prolonged anxiety or grief will cause an emaciation,
second only to that of tuberculosis itself, by the depression

HYGIENE OF MIND AND ITS RELATION TO HEALTH 245

of the heart's action and the circulation, the loss of ap-
petite, the interference with nutrition, and the loss of
sleep.

Worry is, as we have seen, in the first instance most
frequently bred of exhaustion, but, if indulged in, it readily
becomes a fixed habit, and the mind rapidly settles into a
state of fixed gloom.

Worry is a type of fear. It is a futile regret over past
mistakes and the miserable forecasting of the future.
Jt has been called the great shortener of life under civiliza-
tion— of all forms the financial one is the most frequent
and, for ordinary minds, the most distressing.

Anxiety and the anxious frame of mind is in readiness
to take fright in connection with our most vulnerable
points on all occasions of apprehension or uncertainty.
As no one's future can be clear throughout, there is never
wanting the matter of anxiety to a mind susceptible. of
this state.

It is a significant fact that our asylums are recruited
from the classes who spend their lives amid narrow monot-
onous surroundings; hence the large proportion of women,
especially of farmers' wives, whose lives are probably the
most narrow and the most monotonous. From this result
the fixed ideas, the obsessions, and all the absorbing
egotism of insanity.

With a variety of valuable and permanent interests,
the mind is well safeguarded against attacks of worry.
The overworked woman should increase her recreations,
leave home for short intervals, travel, and have entire
rest and change of scene. With increased vigor of body
will come increased power of the will and the capacity to
abolish worry.

Anger floods the brain with blood, and if the arteries are
brittle, as they are in old age, and the individual is just
as old as her arteries, the rise in arterial tension may
result in the rupture of a blood-vessel, and the subse-
quent hemorrhage into the brain may cause an attack of
apoplexy, paralysis, or even death. Attacks of anger

246 PERSONAL HYGIENE FOR WOMEN

hasten the deterioration of the arteries; in this way anger
has been known to cause death.

Every violent physical sensation will react on the lungs;
every powerful normal emotion, whatever its cause, will
also make its influence felt on the respiratory functions.
An exercise which is performed with tranquil breathing if
the mind is free from care, quickly produces respiratory
disturbances if the mind is brooding and preoccupied.
Those who have acted as seconds in a duel to men accus-
tomed to the use of the sword know that they become
breathless in the duel much more quickly than they do in
the fencing school.

Depressing emotions make themselves felt in the respir-
ations of animals as well as of man. A sensitive horse,
which is badly used at its work, or even roughly spoken to,
rapidly becomes breathless.

The dog is incomparably less swift than the hare, but
is able to catch it; the fright of the hunted animal disturbs
its breathing and robs it of much of its strength.

In fright the disorder of the respiratory movements
destroys the regularity of the interchange of gases which
takes place in the lungs, between the venous blood and
the atmospheric air, and thus profoundly hinders the
function of the aeration of the blood.

The more impressionable the subject, the more easily
do the emotions influence his respiratory actions. Hence,
the superiority in certain bodily exercises of men whose
minds are calm and masters of themselves.

Emotional causes, such as worry, anxiety, and grief,
as well as the more tangible physical factors, cause soften-
ing and disease of the tissues, which frequently accounts
for the arteriosclerosis and premature senility. Alienists
have long found abundant evidence that abnormal physical
conditions are capable of producing mental diseases, but
the reverse is quite as true.

And not only the imagination, but the intellect, the
emotions, and the will have or may have a powerful in-
fluence over the sensations and organic functions.

HYGIENE OF MIND AND ITS RELATION TO HEALTH 247

It is not only profoundly true that mental attitude has
much to do with bodily function, capable of producing
changes in its nutrition and secretion, but we may go
further and say that healthful and hopeful habits of
thought do much to put the body on the defensive against
the assaults of disease.

Mental attitude refers not to the will or the emotions,
but to the mind in its entirety. The trend of a woman's
thoughts, the use she makes of her intellect, the strength
of the volition, the sense of responsibility, and the objects
of her life are all questions that have a distinct bearing
upon the bodily functions and the health of the individual.

A Definite Occupation a Physical Necessity. — It is
now generally conceded by the leading sociologists of the
day that women who are not engaged in the duties of
maternity need the same intellectual and industrial ac-
tivities as men. Many go further, and it is their opinion
that there is no reason for excluding women, who are ful-
filing the duties of maternity, from exercising full intel-
lectual and physical activities in other directions. And
the proof that this is not a mere theoretic assumption
is to be found in the fact that many women have not only
given birth to a family of children, but have successfully
reared them, and, in addition, have been eminent in other
pursuits and callings. Well-known illustrations of this
fact are to be found among the most noted sovereigns that
Europe has ever had — Catherine de Medici, Maria Theresa,
Catherine II of Russia, and Queen Victoria.

Pleasure seeking, as the end and object of life, leads to
ennui, disgust, and physical and mental deterioration,
while the slavery of housework, the childish vanities, and
petty cares and vexations are most injurious to the nervous
system, so that for the life of the housewife the education
preceding it should be broad ; and the more highly educated
the woman is, so much the more effectually can she free
herself from attaching too much importance to every little
detail, and so neglecting what is higher and more import-
ant, and it will be a great preventive of irritability of

248 PERSONAL HYGIENE FOR WOMEN

temper, quarrelsomeness, and even melancholia and
mental derangement, from which so many of these women
suffer in consequence of the monotony of their lives.

Every girl when she leaves school, which she should
consider the very alphabet of her education, should
prepare herself for some definite occupation, just as her
brother does.

Clouston, in answer to the question as to how the
powers of the mind can best be developed, conserved,
and made the best use of for life's work, says: "It is a
most fortunate thing, if, during the later period of ado-
lescence, an occupation in life has been selected which
really suits the capacity of the individual and goes with
his innate tendencies. The seriousness and the settled-
ness of the life of the period, with the bracing of every
nerve and sinew to do the work, to gain a reasonable
position in society, and to enjoy a fair amount of happi-
ness, is in itself a tonic of no mean value, while over-
taxing of body and mind is always a risk, as well as an
ambition which overreaches itself. The repressions of
woman's life in civilized society constitute one of her
serious strains and dangers. The life and conditions of
a working woman who has six or seven children in a few
years, who has small means, and but little help, is in my
judgment the very hardest of any human being in our
modern social system."

Thomas1 thus sums up his views as to the evils result-
ing from the non-occupation of women of the better
classes. "Human nature was made for action; and
perhaps the most distressing and disconcerting situation
which confronts it is to be played on by the stimulations
without the ability to functionate. The mere super-
inducing of passivity, as in the extreme case of solitary
confinement, is sufficient to produce insanity, and the
emotion of dread or of passive fear is said to be the most
painful of the emotions, because there is no possibility
of relief by action.

»" Sex and Society."

HYGIENE OF MIND AND ITS RELATION TO HEALTH 249

" The American woman of the better class has superior
rights and no duties, yet she is worrying herself to death;
not over specific troubles, but because she has lost her
connection with realities. Many women, more energetic
and more intelligent than their husbands or brothers,
have no more serious occupation than to play the house
cat, with or without ornament. It is a wonder that more
of them do not lose their minds; that more of them do
not break with the system entirely, is due solely to the
inhibitive effect of early habits and suggestions.

"The remedy for the irregularity, pettiness, ill health,
and unserviceableness of modern women seems, therefore,
to lie along educational lines. Not in general and cultural
lines alone, but in a special and occupational interest and
practice for women, married or unmarried. This should
preferably be gainful, though not onerous or incessant.
Normal life without normal stimulation is impossible,
and the stimulation best suited to the nervous system is
some form of interesting work."

The Psychology of Success. — Success has been defined
as the accomplishment, the realization of what has been
willed or wanted, the ripe fruition of the well-tended tree.
The achievement of fame or fortune is what the world
generally regards as success.

Before entering on an enterprise, all the premises in the
case must be had in order to form correct judgments,
otherwise incomplete and imperfect knowledge of the
case will lead to error in judgment, in which there
could be said to be "no chance of failure, it was a cer-
tainty."

An element that always makes for success is to be able
to supply a want of the public; it is partly a question of
demand and supply. It is sometimes possible to create
a demand. But, as a rule, success is the fruition of
patience and well-directed energy.

There is nothing which tends so much to the success of
volitional effort as the confident expectation of its success,
while nothing is so likely to induce failure as the appre-

250 PERSONAL HYGIENE FOR WOMEN

hension of it. Since the tendency of the cheerful and
joyful emotions is to suggest and keep alive the favorable
anticipations, while that of the depressing emotions is
to bring before the view all the chances of failure, the
former will increase the power of volitional effort and
the latter will diminish it.

The mental condition also exerts a direct influence
upon the physical powers, through the organs of the
circulation and of the respiration, the heart's impulse being
more vigorous and regular, the aeration of the blood
being more efficiently performed, in the former of these
conditions than in the latter.

Success too easily won, or won early in life, may really
be a cause of failure, because, having been once achieved,
the individual may be content with what she has and
not proceed to higher development. And so a very
inferior success may be the tomb of energy and the
satisfied goal of ambition, instead of a stimulus to higher
things.

Lack of success may also be caused by indulgence or
lack of courage, the individual preferring to sail along
the chartered course of mediocrity rather than to strike
out a new path for herself, involving risk, anxiety, and
endless work.

And perhaps jealousy in the rank and file of the lazy, in-
different, and mediocre far more often impedes effectually
the road to success than is dreamed of, so that a greater
degree of secretiveness, warding off the scent, of the
intentions, the aspirations, and the methods of work, until
the object shall have finally been achieved.

Another and most important secret of success is to
recognize failure as only a stepping-stone to higher things.
Eggleston says, " Persistent people begin their success
where others end — in failure."

The people who succeed in this world are the people
who get up and look around for the circumstances they
want; if they cannot find them, make them. "Circum-
stances," said Napoleon, "I make circumstances."

HYGIENE OF MIND AND ITS RELATION TO HEALTH 251

There are four mental requisites necessary to the
achievement of success, namely: a clear view of the end;
a judicious indifference to the sentiment around by the
sweeping away of obstacles; an indomitable energy;
and the power to resist the temptation to rest on the
soporific plane of mediocrity.

CHAPTER VIII

DRESS THE FUNDAMENTAL CAUSE OF WOMAN'S
PHYSICAL DETERIORATION

The History of Woman's Dress; the Corset in History; the
Crusade Against the Corset; the Influence of the Corset on the Female
Body; the Curved Front Corset; the Relation of Corsets to Ab-
dominal and Pelvic Disorders; the Effects of Corsets on the Muscles;
the Straight Front Corset; the Abdominal Corset; the Wearing of
Corsets by Young Girls; What Style of Corset is the Least Injurious,
the Shoe; the Stockings; the Essential Qualities for Winter Under-
clothing; the Length of the Walking Skirt; the Winter Street Dress.

A CAREFUL study of the history of woman's dress affords
a forcible demonstration of the fact that the fundamental
cause of the inferior physique and lowered vitality of
the modern woman of civilization is to be found in not
only her own, but also in her female ancestors' unhygienic
mode of dress for many centuries.

Study the physique and dress of the ancient Greeks,
then follow the history of dress down through the Middle
Ages and the Renaissance to the present time, and, if
further proof be needed, visit, as has been done, the
savage races of the earth to-day, and behold women of
powerful and classic physique still exist in lands where
the body is not molded according to the barbarous decrees
of the "modiste of fashion."

The History of Woman's Dress. — The history of
Greek costume is for the most part free from what is
known as change of fashion, for the reason that the Greeks
did not attempt to reconcile the two opposite principles
of covering, and at the same time displaying the figure;
that is to say, of cutting the dress to fit the body.

The dress of the Greeks, when at the height of their
civilization — and that of the Assyrians, Egyptians, and

252

PLATE II

Greek mstimus. "Queen and two attendants."

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 253

ancient Romans was not essentially different — was very
simple. It often consisted of a simple garment, the tunic,
which pleased the eye by the gracefulness of its drapery,
and at the same time was comfortable by reason of its
looseness.

The chief and indispensable article of female dress was
the chiton, or tunic, consisting of one piece of material,
sewed together in the form of a sack, open at top and
bottom, in height reaching from the neck to the feet of
the wearer, and in width equal to that of the extended
arms. Within this stands the figure, and first it is girt
around under the breasts by a girdle, to keep it from
falling; next the upper edges are fastened together on the
top of the shoulders by a brooch, and the arms are either
left bare, pressing down into folds at each side the masses
of material, or these masses may be gathered around each
arm, and fastened down the outside with buttons and
loops, so as to form sleeves.

To secure greater warmth on the breast and shoulders
the chiton was made long enough to be doubled back at the
top, and this part reached to the waist. Underneath the
chiton was worn a band of cloth, to support the breasts,
and, in addition to this, a cord was sometimes crossed
round the breasts outside the chiton, to assist either in
supporting them or in bringing out their form. Round the
loins was sometimes worn either a short petticoat of thick
woolen stuff or a sort of bathing drawers, such as acrobats
wore. This was all of the essential dress for indoor wear.
The chiton was made of a variety of fabrics, though gen-
erally of linen.

For outdoor wear was the himation, a garment also
worn by men ; it was made of woolen stuff and was worn
like a plaid.

The chiton and himation, as above described, continued
to be the standard dress from 450 B. C. onward.

The hair was most usually worn gathered back from the
temples, and fastened in a knot behind by hair-pins of
ivory or bone, either plain or mounted with gold.

254 PERSONAL HYGIENE FOR WOMEN

For the feet, sandals were usually worn, in exceptional
cases shoes, and for hunting, high boots. Gloves were
never worn by the Greeks, except to protect the hands in
working.

From the time of Pericles, the great European distinc-
tion between male and female dress consisted in the length
of the skirt, old men, priests, and officials being allowed the
privilege of wearing long or women's skirts, and young
girls being permitted to wear the short or man's skirt.
Among the Romans, this single garment, worn by both
sexes, was called the toga.

As time rolled on, this loose cord, which had formed the
girdle, was reinforced by a broad belt or band to support
the breasts. Among the Assyrians this belt was made of
stiffened linen or thin metal; the Egyptians wore a folded
belt; a broad belt for supporting the breasts was also worn
by the Roman ladies. But whatever the material used,
this stay-belt does not show any signs of tight laces or of
vertical ribs of iron or bone. It was, however, the fore-
runner of "stays," and when the moral fiber of the Greeks
grew lax, the courtesans set the fashions, and dress was
used to display rather than to conceal the figure, and, in
order to make the hips more prominent, the waist was con-
stricted by a many-layered belt. At the same time, the
use of cosemtics was introduced.

The Mediaeval or Middle Ages. — From the end of
the fifth century to the beginning of the seventeenth there
was a singular resemblance in many marked particulars
between the dress of the two sexes. It now became the
object of dress in both sexes not merely to clothe the
person, but also to display the figure and adorn it. In
the temperate climates there are always greater changes in
fashion than in the very hot or very cold.

Subjugation by the Romans in the first centuries of the
Christian era was followed by a general conformity to their
mode of dress, so that the Roman dress may be considered
to have become European.

In marked contrast to the loose, flowing robes worn by

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 255

the southern nations of Europe in their decadence were
the short skirts and jackets clinging to the limbs, which
were worn by the hardy nations of the North, who were
given to constant fighting and the pursuit of the chase.
The Norman lords, following the fashion of the south,
swept about in long tunics and flowing robes.

In the twelfth century the Anglo-Saxon women, dressed
in' their loose garments, were indebted to the Norman
ladies for the introduction of "stays," and the fashion of
tightly lacing the body with a robe, laced down in front
in order to show its undulations, as well as the use of cos-
metics.

In the household register of Eleanor, Countess of Leices-
ter, which bears the date of May 24, 1265, is one of the
earliest places in which the word corset occurs. The
word is again found in reference to the wardrobe of Richard
King of the Normans, and Edward his son. Corsets were
at this time worn by men as well as women.

The author of the life of St. Tha'is, who lived in the
twelfth century, tells us that the French were so tightly
laced that they could bend neither their bodies nor their
arms.

Peter the Great wrote that the robes are so tightly
stretched over the body, that the ladies can scarcely breathe
in them, and often suffer very great pain in order to make
their bodies slender.

It was in the thirteenth to the fourteenth century that
the last trace of the Roman drapery gradually disappeared:
the women adopted for the most part the robes with the
tightly fitting corsage, leaving ordinarily uncovered the
neck and the skin of the breast ; this closely fitting corsage
was closed in the back by lacing.

Boots and shoes of this period had their pointed toes
made two or three times the length of the wearer's foot.
The fashions of England were the same as those of France,
though apparently they were not carried to quite the same
excess as on the continent. The singular aim of each sex
was not only to emulate the other in the sumptuous style

256 PERSONAL HYGIENE FOR WOMEN

of dress and its profuse adornment, but also to imitate the
form and fashion of the other's attire; this obtained in both
countries.

The Renaissance. — In the sixteenth century a distinct
separation between ancient and modern dress took place,
and our present fashions took their origin from about that
time. It was during this century that men adopted clothes
closely fitting about the body, overcoats with tight sleeves,
felt hats with more or less rigid brims, and closed boots
or shoes. The women also wore their dresses tightly
fitting to the figure, with tight sleeves, low-crowned hats,
and richly trimmed petticoats. These garments, which
differ wholly from antiquity, constitute, as it were, the
common type, from which has risen the endless variety
of modern male and female dress.

At this time the general resemblance between the cloth-
ing of the two sexes, which may be traced to the earliest
times, became decided. After the accession of Queen
Elizabeth in 1558, the well-known costume, associated
with herself from about the middle to the close of her reign,
gradually became established. The long-peaked and tight
stomachers of the ladies, and the padded quilted doublets
of the men — it might truthfully be said that each garment
was a parody of the other.

Ruffs of an exaggerated amplitude and of a painfully
severe stiffness were worn by both sexes.

At the beginning of the seventeenth century the dresses
were tight at the waist, but begun to be made very full
around the hips, by means of large padded rolls, which were
still more enlarged by a monstrous arrangement of padded
whalebone and steel. To both boots and shoes high heels
were added, in place of the flat heels previously worn.

About 1710 the hooped petticoat was introduced, and
about 1740 they obtained enormous dimensions.

When traced to their original sources, we find that all of
the extremes of fashion were made to conceal some deform-
ity of the figure, or to give to a part of it undue prominence,
as in the case of the corset, which was first introduced when

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 257

clothes were not wanted for the concealment of the person,
but to make more prominent the curves and undulations
of the figure. The ruff grew out of a scrofulous complaint
on a royal neck; the hoop-skirt, to conceal the enceinte
condition of a French queen.

The Corset in History. — Dr. Bouvier divided into five
epochs the transformations undergone by the corset, or
by that part of the clothing which took its place from
earliest antiquity to 1853.

The first epoch is that of antiquity; in this, as we have
seen, the band or girdle, which was worn by the Greek
and Roman ladies, was the forerunner of the corset.

The second epoch comprises a great part of the Middle
Ages. This was a period of transition which partook of
the styles which preceded and followed it. At first there
was an abandonment of the narrow Roman band, and
later the introduction of the corsage fitting tightly about
the body.

The third epoch embraces the end of the Middle Ages
and the first part of the Renaissance, which was marked
by the general adoption of robes with a very tightly laced
corsage.

The fourth epoch is that of the whaleboned corset,
which extended from the middle of the sixteenth century
to the end of the eighteenth.

The fifth epoch is that of the modern corset.

The busk, known since the fourth century, was intro-
duced into France in the sixteenth century; men also
wore busks or stomachers. The busk relates closely to
the history of corsets. The middle of the sixteenth
century is the epoch of transition from the corsage to the
whale-boned waist, which constituted a sensible approach
to the modern corset.

We find that the reign of Queen Elizabeth was marked
by the first use of the whalebone stays. These were much
affected by her successor James, who insisted that all
his courtiers, male as well as female, should cultivate
the appearance of the wasp.

17

258 PERSONAL HYGIENE FOR WOMEN

The corset of George II, represented in Hogarth's
pictures, is said to have been one of the most harrowing
forms of screw torture. We are told that the doughty war-
riors of Gustavus Adolphus wore stays almost to a man.

To Catherine de Medici is generally attributed the
introduction of the closely whaleboned waist into France,
and the corset which she invented resembled in more
than looks that instrument of torture — "The Machine
Virgin of the Inquisition." This corset was made of steel,
and was as inflexible as a suit of armor, and, like a war-
rior's breast-plate, consisted of two pieces. It opened
longitudinally by hinges, secured by a hasp and pin,
made like an ordinary box fastening. In the front and
back a rod or bar of steel projected in a curved direction
downward, and on their bars depended the adjustment
of the long-peaked body of the dresses and the set of the
skirt behind. During the forty years in which she ruled
at court a thirteen-inch waist measure became the accepted
standard.

Madame de SeVigne", born thirty years after the death
of Catherine de Medici, formulated the axiom which
has since been a law to the French modiste, " Les hommes
ont la permission d'etre laid; les femmes ne Tent-pas;
aussi n'en est-il aucune qui consente a 1'etre."

The idea of the waist was unfortunately that which
concerned the execution. Instead of being adapted to
the body or figure, in accordance with its form, to bend
with its movements, as the supple corsage which preceded
it had done, this new garment became an inflexible mold,
which distorted the natural contours and imposed upon
them a conventional mold, and prevented the least
variation of size or situation of the contained organs,
as well as their continued integrity and the proper per-
formance of their functions.

The use of the whaleboned corset prevailed even among
infants scarcely out of their swaddling clothes. This
was the natural consequence of the pretended necessity
to mold the human form in order to obtain beautiful pro-

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 259

portions, to reform nature, and prevent her mistakes,
and one could never take too much care to obtain such
laudable ends. Mothers would have been considered
culpably indifferent of their children who had neglected
these first indispensable cares for the regulation of the
formation of their bodies.

The Crusade Against the Corset.— From the time of
Galen, 130 A.D., to the present day, in spite of the ana-
themas hurled against it by the state and medical profes-
sion, denouncing this great injury which woman does
herself, has the corset still prevailed.

In the thirteenth century, Henry III, having per-
mitted its use for some time, proclaimed a very severe
edict against the wearing of corsets, which was considered
so pernicious to the health of women, but of no avail.

In the fourteenth century an edict was issued by the
Emperor Joseph of Austria, forbidding the use of corsets
in all nunneries and places where girls were educated, and
calling upon the Church to aid him, threatening excom-
munication to those evil-disposed damsels who should
persist in operating upon their waists. The College of
Physicians of that day took up the subject with activity
and zeal, and dissertations upon the evils of tight lacing
were scattered broadcast.

Professor Virchow, that eminent pathologist, wrote,
" What is the use of introducing the principles and appli-
ances of hygiene into the huts of the poor and ignorant,
when the scions of wealth and pretended intelligence,
especially of the gentler sex, show their contempt of
hygiene by their dress and general wearing apparel. In
days gone by I have battled against that diabolical
invention called the corset, but this crusade has been
given up by me as absolutely futile."

The modern hygienist has taken the stand that, since
the corset cannot be suppressed, it must be reformed.
About 1880, for the first time, some attention began to
be given to the hygienic consideration of the style of the
corset.

260

PERSONAL HYGIENE FOR WOMEN

The Influence of the Corset on the Female Body. —

As a result of the four hundred years in which the corset
has molded the plastic form of woman, she has become
physically so degenerated that it is necessary to have
recourse to the artifices of the modiste in order to have
even the appearance of a good figure, and the support
afforded by the corset to maintain the erect position.

The modem corsets, made of one piece, can be classified
in three categories, according to the region of the body

Fig. 13. — Normal chest.

Fig. 14.— Effects of tight lacing
on bony thorax.

on which they exert the greatest pressure. First, the
"curved front" corset, enveloping the thorax and
abdomen, but making the strongest compression at the
base of the thorax; second, the "straight front" corset,
enveloping the thorax and abdomen, but making the
strongest pressure upon the abdomen; and third, the
"abdominal corset," only embracing the abdomen, and
supporting neither the breasts nor the base of the thorax.

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 261

In studying the effects of the corset on the body they
will be considered in this order.

The Curved Front, Corset. — The corset is applied to the
trunk of the body, consisting of the thoracic cavity, a
distensible cage containing and filled by the heart and
lungs; second, the abdominal cavity, whose walls are
almost wholly composed of muscles, and containing the
liver and the entire digestive apparatus; and third, the
pelvic cavity, whose walls are partly bony and partly
muscular.

^'hen the anterior wall of the body is forced to take
the shape of this curved corset, it is pressed back toward
the vertebral column, and even when the corset is not
laced tightly, there is always more or less constriction of
the base of the thorax, so that a serious deformity of the
lower part of the thorax and abdomen is produced; instead
of the normal outward curve of the anterior surface of the
body, with its most prominent part in the region of the
umbilicus, there results a broken line at the waist, and
an obtuse angle is formed here, pointing outward. This
causes a marked incurvation of the lower part of the
chest and its approach toward the spinal column, with a
corresponding flatness of the chest and lessening of the
respiratory capacity of the lungs, and the action of the
heart is seriously interfered with.

The chest or thorax is forced into the shape of a cone,
the lower opening is narrowed, and its walls are brought
too near together. The lower ribs become too short, and,
if the corset is worn early in life, the upper ribs become
too long; and the thorax as a whole is too long.

The greatest constriction produced by the corset occurs
in the plane extending from the ninth to the twelfth
ribs, which corresponds to the position of the diaphragm,
stomach, and liver.

Just how seriously the curved corsets interfered with
the expansion of the lungs was shown in a paper pub-
lished by Dr. Sargent in 1889. He found that the average
lung capacity when corsets were worn was one hundred

262

PERSONAL HYGIENE FOR WOMEN

and thirty-four cubic inches; when corsets were removed,
the lungs showed a capacity of one hundred and sixty-
seven cubic inches — a gain of thirty-three cubic niches;
that is, corsets crippled the lungs to the extent of one-
fifth of their entire capacity.

Nature endeavors to make up this loss by the increased
rapidity of the heart's action and more frequent respira-
tions, but this is at the ex-
pense of greater wear and
friction of the machinery.
Palpitation and shortness of
breath follow, and the woman
is obliged to give up all active
exercise.

Through this failure of the
suction power of the heart
there result disproportionately
larger lower limbs and an ac-
cumulation of adipose tissue
below the waist. This condi-
tion is much more common hi
women than in men, and is
due to the lack of power of
the heart to draw the blood
back from the lower limbs
against the force of gravity.
Hence, the blood tends to linger
hi the lower extremities and
the oxidation of the tissues is
interfered with.
The Relation of Corsets to Abdominal and Pelvic Dis-
orders.— By the constriction of the lower part of the
thorax, as we have seen, the action of the diaphragm is
very greatly impaired; this not only seriously interferes
with its respiratory function, but with digestion as well,
since, by the active contraction of the diaphragm in in-
spiration, it presses down the liver and other abdominal
contents, and produces a powerful massage of those»organs,

Fig. 15. — Diagram show-
ing the action of the curved
front corset (0 'Folio well).

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 263

which aids in the digestion of food and in the unloading of
the bowels, and, at the same time, the pelvic circulation is
interfered with and pelvic congestion is favored.

The direct pressure of the corset upon the side walls
of the chest forces the ribs in upon the abdominal contents;
the liver suffers most from this, and not only does the liver
sometimes actually show furrows upon its surface from
the pressure of the ribs, but, in the postmortem room

Fig. 16. — Relation of bony thorax to lungs, heart, liver, and stomach,
with artificial outline produced by coreeta (after Gray).

of the great Vienna Hospital deep grooves upon the
liver were repeatedly found with great distorsions of the
body caused by the corsets, and, in a few instances, the
left lobe of the liver was found to be nearly separated from
the right.

By the constriction of the waist, the liver and all the
abdominal contents are pushed downward below their
normal position, and their functions are greatly inter-
fered with. The effects of this pressure upon the stomach

264 PERSONAL HYGIENE FOR WOMEN

are most disastrous, and cause a host of digestive and ner-
vous troubles. There is very frequently a prolapsus of
the kidneys; the right one is more frequently prolapsed
than the left, owing to the relation of the right kidney to
the liver.

In a study of 50 cases Dr. Gallant found that in 90
per cent, the stomach was pushed down below its normal
level, and in 80 per cent, there was prolapsus of the right
kidney.

The constriction of the waist crowds the small intestines,
with the accompanying mesentery and colon, into the
pelvis; if the rectum is loaded with feces and the bladder
empty, there follows an anterior displacement of the
uterus; if, on the other hand, the rectum is empty and the
bladder distended, there is a backward displacement of
the uterus. In very many of these cases the compression
and constriction are great enough to interfere with and
retard the peristaltic action of the intestines, and con-
stipation is produced.

Gynecologists are unanimous in the opinion that tight
lacing is a most serious impediment to the development
of the pelvic organs, and is a prominent factor in causing
disease of these organs. Tight lacing displaces the uterus
downward from two to three inches, and, at the same time,
the pelvic floor is bulged downward from two and one-
half to three inches and the circulation rendered sluggish.

When there is no interference with the respiratory
movements the uterus rises and falls with every breath,
and the movements of the uterus promote the circulation
of the blood in the pelvis.

A high corset compresses the breasts, and so interferes
with their development. The low corsets of the present
day support rather than compress the breasts.

The Effects of Corsets on the Muscles. — In the back the
corset forms an extended plane from top to bottom,
destined to support the posterior part of the thorax
and to diminish as much as possible the size and pro-
jection of the shoulder-blades. This compression of the

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 265

muscles of the back leads to their atrophy, and, as it is
their function to hold the spinal column erect and to ap-
proximate the shoulder-blades to the thorax, when they
become atrophied the bony parts become much more
salient. Further, the corset, in weakening the muscles
of the dorsal region, interferes with the normal forward
projection of the chest, and so leads to its flatness.

The corset atrophies the articulations of the vertebral
column, produces a round back, an inequality in the height
of the hips and shoulders, with the resulting familiar
awkward, waddling gait.

When the healthy skeleton offers to the muscles of the
body a solid base of support, the action of the muscles of
the back are not interfered with, there is nothing to prevent
their contraction, and the body is held erect. With a
perfect muscular development, the shoulders are effaced,
the back is admirably straight, and the carriage is erect
and graceful.

The strong compression of the muscles of the abdomen
not only destroys the normal contour of the body, but, by
the atrophy of the abdominal muscles, a partial paralysis
is caused, and so the support which should be afforded the
viscera by these muscles is weakened, and a prolapsus of
the abdominal contents follows.

It will be seen that the two bony cavities of the body
are connected in the back by means of the vertebral column
and are not immovably fixed in relation to each other, but
by reason of the flexibility of the spinal column, they can be
approximated or the distance extended. The suppleness
which results from this mobility corresponds to the physio-
logic needs, and constitutes one of the most essential con-
ditions for gracefulness of carriage.

The movements of extension of the chest are rendered
possible by the action of the muscles of the back, which
hold the trunk erect and extend the vertebral column.

When the corset is applied, the compression and con-
striction fix all those portions of the muscles at and below
the waist; the action of the muscles between the chest

266

PERSONAL HYGIENE FOR WOMEN

and pelvis is diminished at least one-half, so that these
muscles become atrophied from disuse, and when the
corseted woman wishes to straighten up the movement
must be executed by the entire trunk.

Sternum

• The vertical dotted' line
indicates the straight
muscles of the an-
terior surface of the
trunk shown in Fig.
18.

Pelvis

Fig. 17.— Skeleton of head and trunk (O'FofloweH).

Without the corset, the pelvis remains fixed and
furnishes the normal base of support for the thorax,
which gains the erect position through the action of
the muscles of the back acting on the vertebral column.

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 267

Whereas, with the corset on, the pelvis is immobilized,
and it follows the movements of the thorax. The move-
ment of extension of the thorax, instead of taking place
in the region between the false ribs and pelvis, take
place at the hip-joints — the vertebral column remains
rigid, it takes no part in these movements.

Then, as a result of the incurvation of the anterior
surface of the trunk, there is an interference with the

Fig. 18. — Muscles of the anterior surface of the trunk (OToIlowell).

movements of extension of the spine and its immobiliza-
tion, which causes the propulsion forward en masse of
the abdominal contents. The anterior portion of the
chest is shortened, and an exaggeration of the sacro-
lumbar angle is produced.

On the sides of the body lateral flexion of the trunk is
possible, through the contraction of the muscles between

268

PERSONAL HYGIENE FOR WOMEN

the chest and pelvis, but with corsets on this is impossible.
The two cavities are fixed by the rigid armature which
composes the corset. This not only prevents the lateral
flexions of the body, but also causes an unnatural depres-
sion above the crests of the ilium. The waist is con-
stricted to such an extent that the woman can only

fasten her corsets in front by
having them widely separated
in the back.

All these conditions cause
a complete immobilization
of the thorax on the pelvis,
so that the movements of
the upper part of the body
are characteristic in corseted
women, and she moves all in
one piece.

The Straight Front Corset.
— This corset, when worn
loose, is a great improvement
on the curved-front corset.
When properly fitted, all the
compression comes at the
hips and across the lower
part of the abdomen, which
is lifted up, and the waist-line
is increased in size. This
corset has for its base of
support the bony pelvis, and
there should be sufficient space to easily introduce the
hand between the lower part of the thorax and the corset.
In this case there is great freedom of movement of the
entire chest cavity, so that respiration is not nearly so
much interfered with as in the curved-front corset, and
if the corset is properly fitted, the lower part of the
abdomen is raised together with the contained viscera,
and, indeed, this style corset is prescribed in cases of
prolapsus of the kidneys. •

Fig. 19. — Diagram showing
the action of the straight front
corset (OTollowell).

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 269

By having the base of support from the bony pelvis, the
chest is left free, and a good chest expansion and its
throwing forward is favored, and at the same time an
erect carriage is secured.

The waist-line runs below the short ribs, which lengthens
the waist, producing graceful lines without compression.

But not all straight front corsets fill these conditions.
Unless sufficiently long and well fitted about the hips,
they may fail to raise and support the abdomen, and
when too tightly worn may press too strongly upon the
abdomen in the pretext of obliterating it, with the result
that it is placed in a vice from before back. Pressed
down, the intestines find a means of escape at the lower
border of the corset.

The front of the corset is frequently carried too high
up, and does not leave the epigastric region sufficiently
free. The corset must absolutely not be thoracic, and
must definitely renounce the support of the breasts,
which should be accomplished when necessary by an
extra bust supporter. The long straight corset im-
mobilizes the trunk in the same manner as the curved
front corset.

The Abdominal Corset. — In 1902 Madame Gaches-
Sarraute proposed to abandon the thoracic corset and to
introduce instead the abdominal corset. This corset
embraces the pelvis without compressing it, and takes
as the foundation of its support the bony girdle; the plan
of the line of support is oblique, and inclined forward
in such a way that there can be no compression.

In this way the pressure, instead of coming from above
and annuling the contractions of the abdominal muscles,
comes below and reinforces their action; the stomach
resumes its normal position, and is supported in the plane
of its greater curvature, facilitating its functions, so that
digestion will be performed under the most favorable
conditions.

The abdominal corset should not exceed the height of
the false pelvis, should have as the base of support the bony

270

PERSONAL HYGIENE FOR WOMEN

girdle of the pelvis, and should be rectilinear in front
and very slightly curved in the back and below. The
hips should be simply surrounded and their projection
preserved. A curve which follows the normal sinuosity

of this plane joins the piece
from the hips with that of the
abdomen.

The part corresponding to
the back must be sufficiently
wide and free, so that the pos-
terior borders of the corset will
be parallel when it is put on,
and the plane preserved for the
back in the pieces which form
the corset. This garment will
be adjusted without strain in
the back, and it will embrace
the form of the body so exactly
that it can be put on without
being unlaced.

The frame of the corset must
be reduced to a minimum — a
rigid busk in front and some
whalebones in the back; the
hips remain free, and a slight,
separate brace supports the
breasts.

The Wearing of Corsets
by Young Girls. — The greatest
dangers come from putting cor-
sets on young girls who are still growing and are very
imperfectly developed, and later by an undue constric-
tion of the lower part of the thorax and the waist, so
that the development of the entire body and its organs
is seriously interfered with and all beauty of form is
prevented.

The muscles of the back, like those of the abdomen,
are prevented from their full development, and, later,

Fig. 20. — The abdominal cor-
set (O'Followell).

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 271

in their action, by the use of the corset. The earlier the
corset is put on, the more pernicious will be the effects,
because during the period of growth the bony frame-
work is more pliable and delicate, so that a relative slight
compression is sufficient to make an indelible impression
upon the form. Before the complete development of
the hips and the entire bony framework an enormous
amount of harm is done by the wearing of corsets.

In early youth the heart lies higher than in the adult.
By narrowing the intercostal spaces, the heart is retained,
as it were, in its youthful position; in the adult female
the heart is found to lie higher than in the male, and
the contraction of the space in which the heart has to
play is one of the causes of woman's fainting, and it is also
a cause of organic disease of the heart.

At puberty, when the girl is rapidly increasing in stature,
and her menses begin to be a drain on the system, relentless
custom adds the compression of the corset and long skirts,
suspended from tightly drawn bands around the waist.

The spinal column at this age lengthens rapidly, and
it should carry upward all the viscera attached to it;
but, owing to the weight of the clothing and the com-
pression at the waist, this normal process cannot take
place; instead, there is stretching of the ligaments, and
the viscera are prevented from rising and hang at a level
much below the normal.

A girl of this class is apt to be slender, with under-
sized hips, and has a characteristic configuration of the
anterior surface of the body, a hollowing out of the region
over the stomach, and a very great protrusion of the
abdomen.

The uterus remains undeveloped and in an infantile
state until near the approach of puberty, when it develops
rapidly, and continues to increase in size until the normal
size is attained — about twenty years of age. By the
putting on of corsets the free mobility of the uterus and
its appendages and their normal development are inter-
fered with.

272 PERSONAL HYGIENE FOR WOMEN

This period of growth and development is one of the
greatest importance for the future health of the woman,
both physically and mentally, and the most intelligent care
should be given the girl at this impressionable age. By
putting corsets on their daughters at this time, mothers
are doing them a very great wrong, which can never be
entirely atoned for. The corset prevents growth, develop-
ment, and the participation in those exercises which make
for physical vigor and good health. To the well-developed
girl corsets are as much of a superfluity as crutches would
be, and nothing but the prevailing style of dress causes
girls to put them on.

It has been suggested that the wearing of any kind of
corsets before thirty years of age should be a penal
offense; and in case of a minor, the parents should be
fined from one hundred to one thousand dollars.

As regards the wearing of corsets after the age of thirty,
opinion is divided into three clases — first, those who
utterly condemn their use; second, those who approve of
it; and third, those who tolerate the wearing of corsets,
but only under the condition that they shall cause ab-
solutely no constriction.

What Style of Corset is the Least Injurious? — From
the nature of the structure of the chest and abdomen and
the functions of respiration, circulation, digestion, and
the pelvic organs, the wearing of any style of corset must
be more or less detrimental to the health and vigor of
woman, and a perfectly developed woman, in perfect
health, does not need a corset if she lives under normal
conditions of dress and life; but in our present state of
civilization, with the present style of dress, and with the
very imperfect muscular development, women in and past
the prime of life may wear hygienic corsets without any
very great amount of injury.

The type of feminine beauty which approaches most
nearly the ideal is that of harmony of proportions and
modulations of lines. The waist proportions of the Venus
de Milo is 47.7 per cent., while that of the Grecian man is

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 273

46.4 per cent. In proportion to her height the hips of the
modern woman exceed the girth of those of a man by
about four inches, and a woman of the same height as a
man exceeds in hip girth by six inches. If the muscles
which pass from the thorax to the pelvis were properly
developed, the artistic proportions would be preserved, and
the waist of the woman would be proportionately larger
than those of a man.

The ideal figures of the Greek women show a torso
bounded by outward curves, softly melting into one an-
other, until the broadest part is reached at the hips, thence
again declining to the feet. The line from the armpit
to the ankle is one of the chief lines of beauty in sculpture,
while the anterior surface of the body should present, in
the median line, a gentle curve from the upper end of the
breast-bone to the brim of the pelvis, the convexity of the
curve coming about the umbilicus. An inward curve of
this line is a deformity artificially produced.

In order that the corset should become an inoffensive
garment it must be well adapted to the figure, so that it
shall not embarrass the action of the diaphragm or the
vital organs or the movements of the body.

The injurious effects of wearing the curved front corset
have been given, and this style of corset should be con-
demned without appeal, since its use is dangerous from
every point of view.

The straight front corset is much less injurious than the
curved front, but its use is detrimental to health, and
prevents the free movements of the body, so that the
abdominal corset remains the only one which is perfectly
safe and at the same time esthetic.

The chief role of the corset must be to sustain the cloth-
ing and to prevent the constriction of the lines about the
waist and to prevent the falling of the viscera.

This can only be accomplished by selecting the proper
points of support for the corset; this is in the lumbar region
of the spine and the crest of the bony pelvis, a region of
several centimeters in height. Except for the vertebral

18

274 PERSONAL HYGIENE FOR WOMEN

column, the viscera of the region immediately above this
have no bony protection, and are subject to the greatest
amount of constriction, the organs being piled up on top
of each other, as it were, and thereby suffer very great dis-
placement and impairment of function, while, on the other
hand, the solidity of the bones of the pelvis permits of
their use as a base of support for the corset, as well as for
the clothing.

It is based on this idea that the hygienic abdominal
corsets are built, and, further, this style of corset does not
sacrifice the normal curve of the anterior surface of the
body. That the abdominal corsets do not support the bust
is no detriment, as the woman with very fully developed
breasts can wear a bust supporter, entirely separate from
the corset, and in those pathologic conditions of ptoses
of the abdominal contents — and from an orthopedic point
of view, the abdominal corset affords an excellent solution.

In order to prevent misfits, all corsets should be made to
order; the measurements must be taken with the corsets
removed. The corset must be shaped so as to fit exactly
over the hips, with the lower parts of the busks very slightly
curved, following the normal curve of the body. The
upper part of the corset must be a little loose, in order to
permit of the easy movements of the body. Behind, the
line of the corset must correspond to the line of the body,
in order not to interfere with the erection of the body.
In front, the corset overlaps the pubic bones, and must
be tight enough to give the abdominal contents some
support.

Instead of the lacings forming two "V's," the lower V,
with its apex at the waist-line, and the longer V superim-
posed on top of this, the ensemble of the lacings to be
normal must form only one V, with the inferior point
very elongated. The corset is too tightly laced if, when,
with the strings untied at the waist, the upper parts of
the corset separates.

The corset should be put on with the lacings wide open,
be carefully adjusted in the proper position, and fastened

CAUSE OP WOMAN'S PHYSICAL DETERIORATION 275

from below up. After the stocking supporters have been
attached, the lower part of the corset is held down with one
hand, while the other hand gently draws up the abdomen
by means of drawing on the undervest, or slipping the hand
within the corset; in this way the abdominal organs are
lifted up. The corset is then laced from its lowest point
to the waist-line, and from the top to the waist-line, in
such a way that only one long " V " is formed. The laces
are then firmly tied and slipped in under the corset.

Corsets that slip up are probably either too long waisted,
too tight over the fulness of the hips, or there is not suffi-
cient curve in the back and sides at the waist-line. High-
backed corsets are apt to make the woman look round
shouldered, while a low back gives smoother and more
desirable lines.

The Shoe. — The style of the shoe is very closely related
to the corset in the amount of harm it is capable of doing.
Considering the fact that the feet form the base of sup-
port for the entire body, and that on their condition
depends the woman's ability to take a sufficient amount
of exercise and maintain her good health, surprisingly
little attention is given to their care.1

The compression of the foot into a rigid body, not
unlike the shoemaker's last, destroys the natural relation
of the parts, prevents the growth, interferes with the
circulation, compresses the nerves, weakens muscles and
ligaments which should support the arch, and is the prolific
source of corns, bunions, weak ankles, and " flat " foot.

But, in addition to the direct injuries to the feet, the
excessive elevation of the heel displaces the center of
gravity, and transfers the weight of the body for the
most part from the heel to the line of union of the instep
with the toes, a series of joints with shallow sockets
not formed to bear the brunt of the body weight. In
addition to which the equilibrium of the body can only
be maintained by an increase of the natural curves of the
bony framework, with the resulting increased curvature
forward at the small of the back, is an increase in the
1 See pagea 337 and 339.

276 PERSONAL HYGIENE FOR WOMEN

prominence of the buttocks and abdomen. This tilting
forward of the pelvis interferes with the circulation of the
pelvic organs, and their congestion and inflammation follow.

By walking around in her bedroom slippers any one
can easily convince herself of the greater grip that the
foot has on the floor when so clad, and of the greater
ease and sureness in walking; this is chiefly due to the
greater breadth of the sole, and the fact that the slipper
has no heel. The greater firmness of men on their feet
on slippery pavements is doubtless due to the difference
in the cut of the shoe and the lower and broader heel.

The front part of the sole of the shoe must be so de-
signed that the great toe will retain its normal position
and rest on the inner border of the sole. In many shoes
the great toe is forced out of its natural position toward
the middle of the sole, and the tip, instead of pointing
straight forward, is thrust toward the line of the sole.
This not only lessens the thrust of the great toe as it
leaves the ground in walking, but also leads to a malforma-
tion of the foot and ingrowing toe-nails.

The soles of the shoe should project a reasonable distance
beyond the uppers, to give firmer support to the foot and
to protect the soft parts in walking.

The front part of the upper leather must be broad
enough for the free movement of all the toes in walking
and in springing; when it does not give room enough
for the toes to spread outward and forward in walking,
they are bent on themselves. This makes the descent
of hills and all active exercise and games very painful.
Tight upper leather is also productive of chilblains and
corns.

The shoe should be slightly longer than the foot when
the entire weight of the body is placed upon it, and
sufficiently broad for the foot to spread in walking; but, at
the same time, the shoe must fit snugly about the heel
and instep, or else the foot will slip forward in walking,
and all the evil effects of too short a shoe will result.

The heel of the shoe must be broad and low? High

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 277

heels force the foot to keep perpetually and unnaturally
on the stretch ; if they are worn in early youth, they may
bring about permanent deformity of the skeleton and of
the foot. Moreover, the high heel interferes with the
natural walk, in which the pressure of the foot on the
ground passes from the heel to the toes. The high heel
requires that the front of the foot should be set down
first instead of the heel. The result is an awkward trip-
ping gait and a short step, which is very fatiguing. This
is one of the causes for woman's frequent dislike for
exercise in the open air, such as walking, mountaineering,
games, etc., and so the general health is affected.

Again, from the esthetic point of view, the size of the
foot must be in proportion to that of the body. Artists
declare that every foot that has worn a shoe is deformed,
and so, when they wish to make a study of the foot, they
go to the shores of Italy, where the peasant women have
never worn shoes.

Paget's description of a perfect female foot is great
breadth and fulness of instep, a well-marked great toe,
a long second toe, projecting a little beyond the great toe,
and a very small little toe.

Since the feet are the part of the body to come in direct
contact with the greatest amount of cold, whether on the
floor of the house or the pavement of the street, it is a
matter of prime importance to the entire body that they
should be warmly clad. While for house wear and in the
summer time a French kid is a most comfortable shoe,
for street wear and outdoor exercise in cold weather a
heavier leather with thick soles is requisite as a protec-
tion against the cold and damp.

Rubbers should always be worn when the pavements
are damp, even if it is not raining, and in snow-fltorms
and very heavy rains cloth gaiters should be worn over the
shoes, to keep the ankles dry, and later to protect them
from the wet skirts.

The Stockings. — Great care must be taken to have
the foot of the stockings sufficiently long and loose; this

278 PERSONAL HYGIENE FOR WOMEN

is doubly the case with woolen stockings, which are apt
to shrink so much in the wash. A too tight or too short
a foot of the stocking interferes with the circulation and
causes a cold foot, and when the stocking foot is too
short, it produces the same deformities that too short a
shoe does.

The trouble generally begins in childhood; mothers
forget in buying stockings for their children that stockings
shrink in the laundry and that children's feet grow.
The result is that the stocking-foot is apt to be too short
before it is worn out, and so the toes are bent or cramped
together, and there is the starting-point for deformities
of the feet as well as corns and bunions. As much harm
may come from wearing too short a stocking-foot as too
short a shoe.

Again, with the present mode of wearing the stocking
supporters attached to the corset, or, indeed, one of the
functions of the stocking-supporters may be said to
be the holding down of the corsets, the supporters are
shortened for this purpose, and as a result the entire
foot of the stocking is pulled on, and an artificial shorten-
ing of the stocking-foot is produced; and this point must
be borne in mind in purchasing stockings.

Woolen stockings should always be worn during the
cold weather. Garters should never be worn around the
leg, whether above or below the knees, since, in order
to be sufficiently tight to hold the stockings up, they
interfere with the circulation by the constriction of the
leg, and so cause cold feet and greatly increase the trouble
in case of varicose veins.

The Essential Qualities for Winter Underclothing.
— These are that the clothing must be light, loose, warm,
and equally distributed over the body. From the hygienic
standpoint, the underclothing is the most important part
of the dress.

We have seen that much of the energy of the body is
spent in maintaining its normal temperature, and that the
two main functions of the skin are the preservation of the

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 279

normal body temperature and the excretion of certain
effete matters in the form of watery vapors.

In the temperate zones two qualities are required of
underclothing — that it shall prevent the too rapid radia-
tion of heat from the body and that it shall be absorbent.
No material is warm per se. The warmth is necessarily
derived from the body, so that what is required of the
underclothing is that it shall confine the warmth in its
meshes; atmospheric air being one of the poorest con-
ductors of heat, the material should be so constructed as
to imprison a considerable quantity of air in its meshes.

The second necessity is that the excrementitious matters
should be rapidly absorbed, as they are being constantly
poured out from the skin, so that the material must be
absorbent in the highest degree, otherwise the fluids re-
main in contact with the skin to irritate it, and the atmos-
pheric air confined between the undergarment and the
skin rapidly becomes surcharged with gases and moisture,
and so acts like a warm jacket around the skin. Heat
radiation is interfered with and the skin becomes extremely
sensitive to changes of temperature and to drafts.

Wool is a poor conductor of heat and a great absorber
of water. Its powers of hygroscopic absorption is at
least double in proportion to its weight, either cotton or
linen, and this property is an important one. During
perspiration the evaporation from the surface of the body
is necessary to reduce the heat which is generated by ex-
ercise. When exercise is finished, evaporation still goes
on, and, if unchecked, to such an extent as to chill the
body. If dry woolen clothing is put on after exertion, the
vapor from the surface of the body is condensed in the
wool, and gives out again the large amount of heat which
had become latent when the water was vaporized, and
from this cause alone a woolen covering feels warm during
sweating. In the case of tightly woven cotton and linen
fabrics, the perspiration passes through them, and evapor-
ates from the external surface without condensation; the
loss of heat then continues.

280 PERSONAL HYGIENE FOR WOMEN

In addition to this, the texture of wool is warmest from
its poor conducting powers, and it is less easily penetrated
by cold winds. The more readily material conducts heat,
the cooler it feels. The property of the conduction of heat
is in proportion to the closeness of the weave and the
amount of air which it contains. For this reason all
loosely woven fabrics feel warmer than closely woven ones,
on the same principle that the more layers of clothing there
are, the more layers of air will be retained between them.

The recent methods of weaving cotton and linen fabrics
more loosely have materially reduced their general defects
as underclothing in cold weather, and if cotton or linen is
worn next the skin it must be so woven as to give both
thickness and porosity to the fabric.

For the majority of people, during the wet and cold
seasons woolen undergarments are the best. If cotton is
worn, it must be loosely woven, so that it may entangle a
large quantity of air within its meshes.

The underclothing should fit tolerably closely the out-
lines of the figure, without impeding the movements.
Combination undersuits, which reach from the neck to the
ankles, are the best; the weight should be adapted to,the
season of the year, and should be changed with the
weather, regardless of the date of the calendar.

The great disadvantage of woolen undergarments is
the way in which its soft fibers shrink in washing, and after
a time become smaller, harder, and less absorbent. To
avoid this, the greatest care must be exercised in the wash.
Woolen fabrics are sometimes very irritating to the skin,
in which case some of the loosely woven cotton or linen
fabrics must be substituted. In the choice of woolen
undergarments the touch is the best guide ; there should be
smoothness and great softness of texture.

In very cold weather the combination undersuit worn
in the house should be reinforced by " equestrian tights "
for outdoor wear. These come in black and can be drawn
on over the shoes. They are a much greater protection
against the cold and wind than a flannel skirt, anch do not

CAUSE OF WOMAN'S PHYSICAL DETERIORATION 281

possess the grave objection of winding about the legs in
walking in the wind.

Lack of proper clothing of the lower part of the body
is beyond question one of the chief causes of the great
prevalence of pelvic inflammation and of Blight's disease
in women.

But not only is there to be considered the danger of
laying the seeds of disease from going out into the cold air
while the body is too lightly clad, but also that, in order
to maintain the normal temperature of the body in winter
without the aid of warm clothing, requires a greater ex-
penditure of nervous energy, which in turn is the equival-
ent of a large amount of life force. It is not only impru-
dent, but most injurious, to exhaust unnecessarily the
powers, of the body, when mere mechanical appliances,
like clothing, will obviate this continuous expenditure of
vital energy.

Another way in which clothes save the wear and tear of
the body is by diminishing the amount of heat the system
must produce by the oxidation of the elements of food.
When properly clad, there is less loss to the body of its
heat, and consequently there is less food needed to supply
this loss.

The Length of the Walking Skirt. — The present vogue
of having the walking skirt five inches from the ground is
an excellent one, as it not only considerably diminishes
the weight of the skirt, but it interferes much less with the
forward swing of the leg in walking, which otherwise has
to be overcome by the muscular force of the leg. In walk-
ing, the length of the step should be proportionate to the
length of the limb; the leg is carried forward by the un-
conscious swing at the hip.

The chief exertion in walking is caused by the raising
of the foot and leg to the point at which it goes forward
and downward. By any artificial shortening of the step,
such as is caused, for instance, by long skirts, it requires
much more muscular effort to walk the same distance.
Besides which, there is the additional friction of the skirts,

282 PERSONAL HYGIENE FOR WOMEN

which is increased by the slightest wind; this has been
likened to the process of eternally walking through a field
of long grass.

Another most important reason for not wearing long
dresses on the street is that they stir up the dust and col-
lect microbes, and thus contribute materially to the dis-
semination of the germs of disease and subject the wearer
and her family to the risk of infection.

The question of clothing takes an important place in
the hygiene of the lungs. All clothing may be approved
which is sufficiently warm, and which allows of modifica-
tions according to the variations in the temperature, and
does not hinder the movements of the body, and particu-
larly those which are carried out by the respiratory muscles.
In the first place, it is very important that the muscles
about the shoulders should have perfect freedom of
motion, in order that the expansion of the apices of the
lungs should not be interfered with. Clothes which hang
heavily on the shoulders, and especially those which grasp
the neck tightly, are unsuitable. Special attention must
be given to this point in the selection of winter clothing.

In going up long flights of stairs furs and heavy top coats
should be taken off and carried over the arm; this will
prevent much shortness of breath and gasping when one
reaches the top of many flights.

The Winter Street Dress. — The street dress for winter
should be warm enough to prevent a feeling of chilliness,
and yet be light enough to prevent the wearer from be-
coming overheated while walking, or from feeling a sense
of weight of the clothing, which is always a sign of being
too warmly clad.

For outside coats impregnated woolen materials, water-
proof, but at the same time porous, are the best, except
in very heavy rains. A storm coat of some kind should
complete the costume for rain or snow. The woman
should never stay indoors on account of very cold or in-
clement weather, as being housed up and the lack of suffi-
cient exercise make one very susceptible to the ve,ry sud-
den changes for which our climate is so notable.

'CHAPTER IX

PHYSICAL TRAINING THE KEY TO HEALTH AND
BEAUTY

The Ancient Greeks the Most Perfect Type of Beauty; the Cause
of the Inferior Physique of American Women; the Physical Training
of the Japanese Women; Improved Physique as the Result of
Physical Training; Increasing Stature and Improved Physique
of American Men; Report of the Royal Commission of Great Britain
on Physical Training; Physical Training Among the Ancients: the
Influence of Physical Training on the Health and Life of the Indi-
vidual; the Effect of Exercise on Brain Development and Character;
the Physiology and Pathology of Exercise; the Relative Proportions
of a Perfect Female Form; Table of Standard Weights for Women;
the Muscular System; the Benefits of Exercise; Passive Exercise;
Massage; the Balance and Carriage of the Body; Common Defects in
the Carriage of the Body; the Heart's Need of Exercise; the Gym-
nasium in the Campaign against Disease; Gymnastic versus Ath-
letic Training; Exercise after Eating; Effect of Brain Fatigue on
Body Fatigue, and vice versa; Marks for Physical Efficiency;
Advantages Derived from Athletic Sports; Ethical Value of Sports
for Women; Forms of Athletic Games Best Suited to Women.

PHYSICAL training is the key to all beauty of form and
face as well as grace of motion. Beauty without health
is inconceivable.

The Greeks were the devotees of the beautiful, and
they were the most perfect embodiments of health and
beauty the world has ever seen. Their splendid physique
was due to their outdoor life, physical training, which
began in childhood and youth, and was systematically
carried on throughout life, their public baths, and their
athletics, sports and national games. Beauty is the in-
evitable corollary of health.

Ard the Greek artists bequeathed to all future genera-
tions a legacy of untold value, using the men and women
of the golden age of Greece as the prototypes for the most

Ml

284 PERSONAL HYGIENE FOR WOMAN

beautiful statues which the world has ever seen, proving
that through the perfect development of the muscular
system alone can an ideal type of beauty be attained, and
these statues also show that the women of that day were
the physical compeers of the men.

The greatest attention to the physical development of
her citizens was given in Sparta. Girls and young women
were subjected to a similar, though less severe, training
than men and boys. It included running, leaping, wrest-
ling, and throwing the lance; these formed the favorite
contests in the national games. Xenophen says: "The
Spartans are the healthiest of all the Greeks, and among
them are found the finest men and the handsomest women
in Greece." The women of the Teutonic tribes frequently
accompanied their husbands to war, and exhibited in-
tances of the most daring bravery.

History, as well as these magnificent legacies in marble
and on canvas, teaches us that no greater fallacy could be
imagined than that "we are women, and therefore weak."
On the contrary, " We are weak, because it never entered
into our thoughts that we might be strong," and it has
been repeatedly proved that physical deterioration can be
overcome by exercise, and that the same means greatly
increases the mental capacity.

In savage races women are the equal, if not the su-
perior, of the men, and woman's smallness of stature,
physical inferiority, and lessened powers of endurance
must be attributed to the customs of civilized society
carried on for hundreds of years.

The Cause of the Inferior Physique of American
Women. — The majority of American girls and women of
the present day have undeveloped muscles, a bad carriage,
an impaired digestion, and are without skill in outdoor
games, and unable to ride, row, or swim.

From the measurements of twelve hundred boys and
girls, Professor Sargent ascertained that at the age of
fifteen years boys are three-quarters of an inch taller than
girls, but that the mean height in the two sexes is the same,

PHYSICAL TRAINING THE KEY TO HEALTH 285

and that, taking the sum of the measurements of the head,
chest, waist, legs, and arms, the mean total was equal in
boys and girls. The sum of these measurements is regarded
as indicative of the strength of the individual, but that, as
a matter of fact, it was found that the girls did not com-
pare favorably with the boys in point of strength. In
capacity of lungs the girls were seventy cubic inches be-
hind the boys, and that, in strength of the expiratory
muscles, the weakest boy was stronger than the average
girl. In strength of back, leg, chest, and arms, the show-
ing of the girls was a little better, though considerably
below what it should have been.

At twenty years of age the man was found to be five
inches taller and twenty pounds heavier. The superiority
of the male in strength was now much more apparent than
at an earlier age. He now presented ninety cubic inches
greater lung capacity and one hundred and forty-three
pounds, greater strength of legs, while the muscular power
of the arms and chest was more than double that of
woman. The charts showed that women were physically
inferior to men in almost every particular.

Dr. Sargent then goes on to say, "The principal char-
acteristics of general form that distinguish civilized women
from men are smaller muscles, sloping shoulders, broader
hips, and shorter legs. The smaller muscles and the
shorter legs may be said to be embryonic, while the super-
ior breadth of the hips indicates a greater evolutionary
advancement in this part of the body than has taken place
in man. The constricted waist must be regarded as a
deformity artificially produced. When the hips are large
in the male or female, the waist will naturally be larger if
the muscles which connect the trunk with the pelvis have
nothing to constrict them. Since the hips of women are
much wider than those of men, we should expect to find the
waist proportionately larger in women than in men.

In close antithesis to these observations of Dr. Sargent's
on the physical inferiority of American women to men,
it is both interesting and instructive to note those of Dr.

286 PERSONAL HYGIENE FOR WOMEN

Hancock in his work on "Physical Training for Women
by Japanese Methods."

The Physical Training of the Japanese Women. —
A Japanese woman is usually the peer of a man of her own
race who is of the same age and height, especially when
weights are about equal. This is due to the fact that the
Japanese women exercise in much the same way that the
men do, and devote fully as much time in the endeavor
to gain strength.

In the Japanese system of bodily training, known as
jiu-jitsu, it is considered advisable in the initial stages to
have boy and girl contestants as nearly equal in age and
height as possible. The girls enter the arena upon equal
terms with the boys, and have proved their fitness to do so.
Grown men and women practise together; other conditions
being equal, the women show an equal amount of strength
with the men.

The back of the average Anglo-Saxon woman is gener-
ally the weakest part of her body, while the normal Jap-
anese woman satisfies the artist's ideals as well as the
surgeon's. The average Japanese woman of to-day shows
a figure as perfectly molded, and of as true proportions,
as the women of ancient Greece were able to display.1

First of all, the Japanese women are taught that life
is impossible without a sufficient supply of fresh air.
This internal cleansing with air is deemed of more impor-
tance than the bath which follows soon after. That the
Japanese woman is a deep breather is shown by the firm
muscles that stand out on the abdomen.
. Consumption is a rare disease in Japan; even winter
coughs are of rare occurrence. The Japanese look upon
full, deep breathing as being the most vital function in
life; food is not so important, although it is necessary.
The best exercises are of little importance when the breath-
ing which accompanies them is not properly done.

Improved Physique as the Result of Physical Train-
ing.— Dr. Mary Taylor Bissell, formerly the medical
director of the New York Berkeley Ladies Athletic Club,

PHYSICAL TRAINING THE KEY TO HEALTH 287

and one of the pioneers in the systematic physical training
for women, gave as the result of her experience there,
"The gain of twelve months' exercise in the gymnasium
is, for the chest two inches, stature two inches, and an in-
crease of 30 per cent, in the lung capacity; many of the
strength tests were doubled, the spine became erect and
the arm vigorous, and the girl gained for herself the con-
sciousness of controlling her own body instead of having
it control her."

Increasing Stature and Improved Physique of
American Men. — Dr. Bern's measurements of Yale
athletes and students suggest the inference that American
men are becoming physically greater than any other known
race. Comparing averages in 1903 and 1908, it appears
that Yale men are one inch and a half taller than their
predecessors of five years ago; they are twenty-seven
pounds heavier, broader chested, and have an increased
iung capacity of seventy-two cubic inches.

The measurements of Harvard students, published last
fall by Dr. Sargent, corroborate Dr. Bern's deductions,
that American college men have larger and more vigorous
bodies than their fathers.

Dr. Sargent's association of vigorous brains with strong
bodies is borne out by Professor W. T. Porter's examina-
tion of 30,000 school-children in St. Louis in 1893, and by
subsequent observations made by other men.

It is the opinion of Dr. Crampton, director of physical
training in the New York city schools, that this improved
physique in American men, observed in the universities,
is not in a small measure due to the fact that within the last
five years athletics have been introduced into the public
schools, so that there are now hundreds of teams of base-
ball, football, basket-ball, and track athletics, where there
was only one before, so that already the colleges are re-
porting that the young men entering them are bigger than
they were ten years ago.

Professor Phillips of Amherst thinks that the young
women are certainly one inch taller and five pounds heavier

288 PERSONAL HYGIENE FOR WOMEN

than they were ten years ago. This improved physique
of Americans he attributes, like Dr. Crampton, to the fact
that the American boy has now come in for his heritage of
athletic sports, and he makes a strong plea for "adult
play" — that every man and woman should have as good
an opportunity as boys and girls to get out on an open
space and play baseball, football, hockey, run, jump, and
have a good time.

To show the importance which Great Britain places
»n physical training for boys and girls the following
report of the Royal Commission of that country for 1903
is given under the caption " A National System of Physical
Training."

Report of Royal Commission of Great Britain on
Physical Training. — " (1) Physical training should be
regarded as of equal importance with mental training.

"(2) During school life physical training is quite as
important for girls as for boys.

" (3) Systematic physical training is necessary both for
country and town children.

"The daily walk to school is exercise, but not exercise
which develops the body as a whole, or counteracts
the liability to stoop, to be round-shouldered, or to be
slovenly in gait. Moreover, all children during school
life must spend many hours with but little change of
position, the effects of which can only be corrected by
systematic physical exercise.

"It should aim at the healthy development of the body,
as well as of the mind, by the regular development of all
the muscles, the quickening of the intelligence and
activity, and the formation of the habits of prompt
obedience, precision, smartness, and discipline. The
exercises should not be for mere display or entertain-
ment, but each should have its particular purpose and
value to develop all parts of the body.

"A certain amount of physical exercise once a day or
oftener is preferable to even a greater amount, at longer
or irregular intervals. .

PHYSICAL TRAINING THE KEY TO HEALTH 289

"Games are very useful and ought to be encouraged,
but they cannot be played by all children, and usually
the weaker ones go to the wall ; that is, those most needing
systematic development are excluded. Games affording
opportunities for violent exercise are useful for the
development of reserve strength, and form an admirable
field for the cultivation of social and public spirit. We
strongly favor their organization and development at all
schools.

"For boys, in addition to the regular games, country
runs, leaping and dancing the Highland Fling; for girls,
skipping and hockey. For both, swimming is strongly
advised."

Physical Training Among the Ancients. — Greek
culture regarded the individual as valuable in and for
himself, and sought to promote first of all his full and
free development. The idea was symmetry and balance
of parts, and, to attain complete and harmonious man-
hood, mind and body were trained together.

Games played an important part in the life of the
Athenians, and their importance in the education of
children was early recognized.

From the age of seven to sixteen it is probable that
one-half of the day of the Athenian boy was spent in
intellectual and the other half in physical education.
The aim of the Athenian education was to produce men,
independent but respectful, freedom loving but law
abiding, healthy in mind and body, clear in thought,
ready in action, and devoted to their families, their
fatherland, and their gods.

Gymnastics included everything relating to the culture
of the body.

The culmination of the Athenian education was danc-
ing. As a supplement to gymnastic culture, it toned
down the ardent exercise of the gymnasium and the over-
energy of muscular development to the ease and grace
which was the Athenian ideal.

The Romans. — The early Romans possessed some traits

19

290 PERSONAL HYGIENE FOR WOMEN

in common with the Spartans. They were intensely prac-
tical and interested in those things whose usefulness was
apparent. Education should fit a man for his work in
the world.

A Roman structure, quite as characteristic as the Greek
gymnasium, was the public bath or therma, found not
only in Rome, but in every important provincial town
in the days of the empire. Both made provision for
exercise and contained a system of baths, but in the
thermae the baths occupied the greater part of the space,
and the rooms and courts for exercise were smaller and
fewer.

The Influence of Physical Training on the Health
and Life of the Individual. — If we believe, with Spencer,
that "Education is preparation for complete living,"
we must appreciate that good carriage, bodily control,
physical judgment, will power, and courage are an im-
portant part of the equipment of every man and woman.
These qualities are intimately associated with motor
coordination, and they are best developed through
physical training.

The power of self-preservation, by which the individual
is enabled to handle his body easily under all conditions,
and so escape physical injury and death, depends upon
physical judgment of time and distance, and the ability
to run, jump, vault, climb, and swim. These are all
fundamental exercises.

The love of play and the ability to play a number of
games contribute very largely to health and happiness.
The play habit must be acquired in youth or it will never
be developed.

The best qualities of mind and character can only be
obtained through physical experience and physical
struggle. With stalwart physique comes a vigorous
type of womanhood, physical courage; with flabby muscles
there is apt to result flabby thinking and flabby acting,
superficiality, and inefficiency. Next to hunger the most
dominant instinct is the play instinct.

PHYSICAL TRAINING THE KEY TO HEALTH 291

The Effect of Exercise on Brain Development and
Character. — The growing interest in preventive medicine,
and the very great popularity of the opportunities afforded
for athletic training, attest to the value which people
are beginning to place upon health as an asset in their
social, domestic, business, and professional lives.

But it is not generally or sufficiently understood just
how great is the effect of physical training on the develop-
ment of the brain or upon the mental activities. With
a strong, vigorous action of the heart there is a feeling of
courage and general exaltation, whereas with a weak
heart and enfeebled circulation, fear and impaired mental
activity predominate.

The manner in which the organic functions are per-
formed not only determine the health of the body, but the
temperament and character as well. There is a conserva-
tion of energy in the fashioning of the will — only part
of the energy is expended in the outward effort, while
the rest goes to lay the foundation of a future will, so that
exercise builds up faculty and conduct character.

We cannot perform an act voluntarily unless we know
what we are going to do, and we cannot know exactly
what we are going to do until we have learned to do it.
The very simplest movement brings about a change
in the organic structure of the brain, and this change
leads to more complex movements and further improve-
ment in brain structure. Most skilled movements give
more exercise to the central nervous system than to the
muscles. Movements calling for a high degree of skill,
correlation of the different senses, sense discrimination,
fine coordinations, and a rapid and responsible exercise
of judgment, all tend, through the action of the association
fibers, to a high degree of brain development.

An essential feature of exercise is that a part of it at
least shall afford amusement, diversion, and recreation
to the overwearied and harassed brain. Hence, the
necessity to introduce dancing, field sports, etc. By
these means industrial efficiency, communal morality,

292 PERSONAL HYGIENE FOR WOMEN

and social consciousness are promoted. Public amuse-
ments of a proper sort are a public necessity.

The great menace to the city is the limited opportunities
for healthful play, and over one-third of the population
of the United States live in towns. The physical side of
the question is the largest, for it involves health, and
consequently poise and self-control. It involves a legiti-
mate occupation of surplus energy and its wise direction,
and it also involves companionship.

The great object of physical training is then to secure
the most perfect development of the body, with the
corresponding development of the brain, so that the
highest physical and mental efficiency of the individual
may be attained.

The possession of a large reserve of muscle and nerve
force, ready to be used in any emergency, gives confidence
to the individual, increases the spirit of taking the initia-
tive and undertaking grave responsibilities that come
into the life of every woman, especially those who are
engaged in the business or professional world, and the
building up of this necessary reserve force is one of the
inestimable advantages of a gymnastic and athletic
training.

The Physiology and Pathology of Exercise. — Exer-
cise is divided into active or voluntary and passive.

Passive exercise does not require any exertion of the
will power. Massage increases the local nutrition of the
parts, stimulates the nerves, and is restful, rather than
exhausting, to the overwrought brain and wearied nerves.

Active exercise is further divided into exercise of
effort and exercise of endurance. Under exercise of
effort are classed all gymnastic feats. The primary object
of a gymnastic training or education is to produce a
symmetric development of the entire body, while, on
the other hand, the training necessary to execute gym-
nastic feats produces an overdevelopment of one part
of the body at the expense of the rest, as is seen in the arm
of the blacksmith and the leg of the danseuse. All

PHYSICAL TRAINING THE KEY TO HEALTH 293

exercises of effort, whether of strength, skill, or speed,
demand and cultivate mental concentration, a rapid
response of the muscle to the orders of the will, develop
the power to accomplish complicated coordinations,
and the knowledge of how these difficult movements
may be performed with the least expenditure of nerve and
muscle force. Exercising a muscle develops it up to its
physiologic capacity, but if a muscle is habitually over-
worked, pathologic results occur, and instead of a quick,
sharp contraction of the muscle, the contractions will be
weak and uncertain, and, if carried too far, the muscle
may eventually atrophy from overwork.

Exercises of endurance include walking, running, swim-
ming, and rowing — the range of movement in these is much
more limited than in exercises of effort. In these, each
movement is well within the individual's powers, yet, by
increasing the rapidity of the movements, or by their
prolonged continuance, the total amount of muscular
work accomplished may be very great. Normally, the
contraction and relaxation of the muscles are compara-
tively slow, so that the poisonous waste matter produc-
ing fatigue is continually being removed from the tissues,
and not allowed to accumulate; whereas, in exercises
of effort, there is no time allowed for the scavengers
to work, and fatigue of the most active muscles sets in
rapidly.

Fatigue may appear in several forms, depending on the
character of the exercise which produced it. When the
exercise is sufficiently active, the amount of waste matter
thrown into the circulation is greater than can be elimin-
ated by the lungs; breathlessness and palpitation of the
heart result; so soon as the equilibrium between waste
production and elimination is established, the individual
is said to have gotten his second wind. Or, again, a slow
pace, too long kept up, will produce exhaustion, so that the
products of tissue waste accumulate, the beat of the heart
is fast, irregular and weak, the nervous system becomes
stupefied, and the muscles fail to respond to the normal

294 PERSONAL HYGIENE FOR WOMEN

physiologic stimulus. This is a form of fatigue not in-
frequently found among zealous housewives, in which the
demands made upon the nervous system by continual and
carking family cares, added to the very strenuous work of
the household, exhausts both nervous and muscular sys-
tems.

Recovery from this form of fatigue takes a much longer
time than the preceding. The individual is too tired to
sleep, the night is troubled by disturbed dreams, there is
a soreness and stiffness of the muscles and joints which
remain for some days. There may be an actual rise in
temperature, and the urine passed has a high specific
gravity, with sometimes even albumin.

If, now, this overwork is continued over prolonged per-
iods of time, without allowing sufficient time for the neces-
sary recuperation, there follows a slow and profound ex-
haustion, which is much more difficult to overcome. In
this condition the temperature becomes subnormal, the
weight decreases, the skin and muscles become flabby, and
the skin is pale, the eyes are dull and listless, and the indi-
vidual is without ambition to rouse herself from her
lethargy.

During a contraction each muscle-cell shortens and
thickens, giving off some of its substance into the lymph-
space which surrounds it, and absorbing food, consisting of
carbohydrates and oxygen, from the surrounding plasma.
Exercise improves nutrition by the rhythmic, automatic
massage caused by the contraction and relaxation of the
muscles on the vessels which they contain, while warmth
favors the elimination of waste matter,

It has been proved by Hawk, of the University of Penn-
sylvania, in his experiments on the blood-count of an
athlete in training, that various forms of active muscular
exercise produce an average increase of 16.8 per cent,
in the number of red corpuscles. When exercise is long-
continued, the rate of increase lessens, and, further, the
number may be decreased in greatly prolonged violent
exercise. The explanation of this is that a large number

PLATE III

Senegalese woman. (From Stratz, after I>r. Kykens, in Shufeldt's
"Studies of the llumun Form.")

PHYSICAL TRAINING THE KEY TO HEALTH 295

of cells lie inactive in various tissues of the body until
they are brought into the circulation by muscular exer-
cise.

Athletic training has been called "mainly heart train-
ing." Exercises of endurance do not require supreme
efforts, but they do accelerate the action of the heart and
lungs, and the aggregate of work done is very much greater
than in exercises of strength, but the exercise must be
sufficiently active to provide for the free circulation of
lymph, which is carried on mainly through the massage of
muscular contraction.

If a walk be so listless that there is not sufficient move-
ment of the muscles to overcome the pernicious influence
of gravity acting on the column of blood contained in the
veins of the abdomen, thighs, and legs, the vessel-walls
may become permanently overstretched and varicose.
The exercise must be sufficiently active for the muscular
contractions to empty the lymph-spaces and hasten the
circulation. It usually raises the general bodily, as well
as the local, temperature of the parts, and so facilitates the
removal of the waste-products.

The acquirement of skill lies in the training of the nerve
rather than the muscle. A simple movement requires
only a nerve impulse to the acting muscle, while a com-
plicated movement requires a wave of impulses to the
accessory and antagonistic groups of muscles which control
and steady the movement. It is easy to see how, in the
first efforts to perform complicated movements, the con-
tractions of the muscles will be jerky and inaccurate,
many useless muscles will be employed, and the expendi-
ture of nervous energy will be out of all proportion to the
result, and these first attempts at new feats of skill rapidly
exhaust the attention. This is well illustrated in the first
efforts of a child learning to walk.

Exercises of strength and skill train that alertness of
mind so essential in ordinary life. They shorten the period
between thought and action, producing what is known as
"presence of mind."

296 PERSONAL HYGIENE FOR WOMEN

The Relative Proportions of a Perfect Female
Form. — The relative proportions of a perfect female form,
as deduced by modern sculptors from the Greek statues,
are as follows: With a height of five feet five inches, the
weight should be one hundred and thirty-eight pounds.
The woman should, with the arms extended, measure
from tip to tip of the middle finger, five feet five inches;
that is, exactly her own height. The length of the hand
should be one-tenth, the foot one-seventh, and the di-
ameter of the chest one-fifth that of the height. The
distance from the perineum to the ground should meas-
ure the same as from the perineum to the top of the
head. The knee should be exactly midway between the
perineum, and the heel. The distance from the elbow
to the little finger should be the same as the distance from
the elbow to the middle of the chest. The measurement
from the top of the head to the chin should be the same as
the length of the foot, and there should be the same dis-
tance between the chin and the armpits. A woman of this
height should measure twenty-nine inches around the waist,
thirty-four inches around the bust, if taken under the arms,
and forty-three inches if measured over them. The upper
arm should measure thirteen inches and the wrist six inches.
The calf of the leg should measure fourteen and one-half
inches, the thigh twenty-five inches, and the ankle eight
inches.

The table on page 297, compiled by Dr. Weisse, the Med-
ical Statistician of the New York Life Insurance Company,
"A Table of Standard Weights for Women/7 is based on
the average weights of over 58,000 insured women, and is
given to show the normal relation between the height and
weight. A point of extreme interest in the table, and one
that is not generally recognized, is the variation in weight,
independent of the height, at different ages.

PLATE IV

Juno.

PLATE V

Yfiius (K- ('aj)u

PHYSICAL TRAINING THE KEY TO HEALTH 297

ag!^

S.o- ~
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s?

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298 PERSONAL HYGIENE FOR WOMEN

Dr. Weisse found the average height of women to be five
feet four inches, and the average weight one hundred and
thirty-three pounds/and that the average male height was
three inches greater than that of the female.

Women should range in weight from one and eight-tenths
to two and two-thirds pounds to each inch in height. In
order to determine your own factor in this respect divide
your weight in pounds by your height in inches. Any
weight above two and one-half pounds to the inch in
stature may be considered as excessive, inasmuch as it adds
nothing to one's mental or physical efficiency, and is fre-
quently the forerunner of obesity, the remedy for which
is to live on a selected diet and to burn up more through
exercise.

In an ideal condition there is a sufficient quantity of
fat to give a pleasing rotundity of outline. In women
the tendency is for fat to accumulate, especially after
forty years of age, about the waist, abdomen, and upper
part of the thighs. In addition to the unsightliness
which this gives to the figure, it is often the indication
of the fatty degeneration of the muscles, and the heart
is liable to become involved, and fatty degeneration of
the heart is one of the frequent causes of death. The
lack of use of the muscles in these regions of the body,
which is caused by wearing corsets, is the reason for the
accumulation of fat here. It can be reduced by the
proper exercises and regulated diet.

The Muscular System. — The bony skeleton forms
simply the framework of the body, and, while it determines
the general outlines and height for the most part, the
weight and general size of the body depend upon the
muscular development and the amount of adipose tissue.
The bones are not only padded about with muscles, but
the muscles are inserted into the bony sheaths in such a
way that a development of the muscles causes a develop-
ment of the bones as well. Again, the stature is increased
by the erect position of the spinal column, and this can
only be attained by great strength of the muscles which

PLATE VI

PLATE VII

Venus de Milo.

PHYSICAL TRAINING THE KEY TO HEALTH 299

hold the spine erect. The inequalities of the muscles are
filled out with adipose tissue, giving a pleasing contour
to the face and figure.

There are some five hundred muscles in the human
body; these muscles vary in size and form, according to

Fig. 21.— The skeleton (Lewis).

their situations in the body and the functions which they
are called on to perform.

Nearly all the muscles in the body are arranged in
two different or antagonistic sets, and are placed on the
opposite sides of the part, so that in acting — that is, by

300

PERSONAL HYGIENE FOR WOMEN

their contractions or shortening — they move the limb
in opposite directions, and it is by the alternate contrac-
tion, or shortening and relaxation of the two sets of
muscles, that the movements of the body are accomplished.
The muscles which bend the joints are called flexors,
while those that extend the joints are called extensors,
so that in order to perform their work, which is that of
contraction, the muscles must exert enough force to
elongate the opposing muscles, overcome the tonicity
of the antagonizing muscles, and lift the weight of that
portion of the limb into which they are inserted. It is

Fig. 22. — Muscular fibers,
highly magnified.

Fig. 23. — Different directions of
fibers in the three layers of abdom-
inal muscles.

by the action of the muscles that the body is held
upright.

Action of the Muscles of the Abdomen. — The trunk is
maintained from falling backward by the action of those
huge muscles on its anterior surface. The space between
the pelvis and the thorax is called the abdominal cavity.
Its walls are almost wholly composed of muscles. There
are several important facts to be noted about these
muscles. First, that they extend from the brim of the
pelvis, into which they are inserted, to the ribs and breast
bony, to which the other ends of these muscles are attached;

PHYSICAL TRAINING THE KEY TO HEALTH

301

that there are three layers of these muscles; and, lastly,
that the fibers of the different layers run in different
directions, so that they cross each other, as shown in the
figure. The reinforcement of the layers, the arrange-
ment of their fibers, and the manner in which they dove-

Fig. 24. — Muscles of the anterior surface of the trunk (left ride,
superficial; right ride, deep).

tail into the adjacent groups of fibers give a structure of
the greatest possible strength.

Action of the Muscles of the Back. — The trunk is kept
from falling forward by the action of the muscles of the
back. These are arranged in six layers. The cut shows
the direction of the fibers. The first, or outside layer,
consists of the trapezius and latissimus dorei, or, in other

302,

PERSONAL HYGIENE FOR WOMEN

words, the broad muscle of the back. On the one side
these muscles are attached to the spines of the vertebrae;
the sharp ridge which is felt in the middle of the back,
and the broad attachment to the pelvis afford a firm base
of support. There are other muscles which run parallel

Fig. 25. — Muscles of the posterior surface of the trunk (left side,
superficial; right side, deep).

with the spinal column, whose function it is to hold the
spinal column erect.

Standing erect calls into action almost all the muscles
of the lower extremities, trunk, and neck. So long as
the line of gravity falls within the line of the feet, the
muscular effort required is so slight that it is little more
than the tonicity contained in all living musCle. The

PHYSICAL TRAINING THE KEY TO HEALTH 303

greater the displacement of the line of gravity, the greater
the muscular effort required to maintain the equilibrium
of the body.

Muscular Energy. — The muscles of the body, even when
at rest, are under a slight degree of tension. When stimu-
lated, the muscle contracts — that is, it becomes shorter
and thicker. A muscle can only remain in a state of
contraction for a few seconds, because the force of the
muscular fibers is more or less exhausted during contrac-
tion. The more rapid the contractions, the sooner does
fatigue manifest itself.

Like the steam engine, the muscles of the body, in
performing their work, produce heat and motion. The
fuel which supplies this force is taken into the body in
the shape of food; it is prepared for use in the intestinal
tract, and from there carried by the blood, to be stored
up in the muscles and various tissues as latent force.
The muscles contain one-fourth of all the blood in the
body.

Heat Production. — By watching a muscle when con-
tracting, we see that there is not only a change of shape,
but a dilatation of its blood-vessels, that is, more blood
passes through a muscle when it is contracting than
when it is at rest, and this increased flow continues for
some little time after the contraction has ceased; there
is also a rise of temperature. Nearly three-fourths of the
heat developed in the body is produced in the muscles
at the actual moment of muscular contraction. Hence,
we learn that the whole body is heated by muscular
exercise; the even temperature of the various parts is
maintained through the circulation of the blood. This
combustion, going on throughout the entire economy,
is the source of all force or energy in the body. In every
movement, every breath taken, in the change even of a
muscle of expression or the conception of a passing fancy,
combustion has occurred and potential force has been
liberated.

Muscular Fatigue. — The fatigue produced by muscular

304 PERSONAL HYGIENE FOR WOMEN

contraction may be due to the consumption of the readily
available material present in the muscle, to the consump-
tion of the supply of oxygen, or to the presence of the
products of combustion, and, if Weichardt's theory is
correct, to these must be added the presence of a definite
"fatigue toxin."

During repose the internal changes of the tissue manu-
facture new explosive material out of the comparatively
raw material already present in the fiber, and the directly
hurtful products of the act of combustion are either carried
off, or undergo changes by which they are converted into
comparatively inert bodies. A stream of fresh blood
may exert its restorative influence, not only by quickening
both of these events, but also by carrying off the immediate
waste-products, while, at the same time, it brings new raw
material.

Every movement of the body depends as much upon
the proper coordination of the muscles for its accuracy,
grace, and force as upon the strength of their contraction,
and while the fatigue, of which we are conscious hi our own
bodies after prolonged or unusual exertion, arises partly
from the exhaustion of the motor nerves, it is chiefly
from the exhaustion of the central nervous system con-
cerned in the production of voluntary impulses. A man
who feels absolutely exhausted may, under excitement,
perform a very large amount of work with his already
wearied muscles. The will rarely, if ever, calls forth
the greatest amount of contraction of which the muscle
is capable.

Passive Exercise : Massage. — Massage has been de-
fined as the systematic manipulation of the surface of the
body by the hands of the operator in movements of strok-
ing, pinching, kneading, and striking. The passive move-
ments consist of flexions, extensions, rotations, and other
movements of joints and limbs by an operator or machine
without the cooperation or resistance of the patient.

Massage takes the place of voluntary muscular move-
ment, in promoting the flow of lymph and the flow of

PHYSICAL TRAINING THE KEY TO HEALTH 305

venous blood toward the heart, if the proper direction,
that of rubbing toward the heart, be followed; while,
on the contrary, rubbing down a limb or from the heart
actually retards the process which it is meant to facilitate.
Gentle rubbing of any part of the body promotes growth,
while vigorous rubbing removes superfluous fat.

Massage finds its widest field of usefulness in conditions
of fatigue, where the elimination of waste matter must be
assisted, and where the nutrition of a part is impaired or
destroyed. Muscles can be improved in size, tone, and
nutrition; ligaments can be stretched and lengthened,
the general circulation accelerated, and overloaded veins
made to disgorge their blood. The digestive tract can be
stimulated, and overwrought nerves soothed and relieved
of their hypersensibility.

The nourishment of the muscle-cell is improved by forc-
ing out the products of fatigue and keeping it bathed in a
constantly renewed stream of arterial blood. This alone
is sufficient to prevent wasting of substance in conditions
where active movements are impossible.

Massage relieves the nervous system by maintaining the
nutrition of the muscles, without the expenditure of nerve
force required to make them contract. It acts on the
central nervous system through the nerves of sense, stimu-
lating or soothing them, according to the nature and the
amount of the manipulation.

Mosso and Maggiora, of Turin, have proved, by their
experiments as to the effect of massage on the muscles,
that muscles were capable of doing twice as much work
after massage. It was also discovered that extending of the
period of the massage did not produce any greater results
in the capacity for work; the full effect was obtained in
five minutes.

The action of massage in improving muscle tone, in
postponing the onset of fatigue, and hastening recovery
from it has long been recognized by athletic trainers.
After a hard race or other contest, it is a matter of knowl-
edge among trainers that a five minutes' treatment will
20

306 PERSONAL HYGIENE FOR WOMEN

enable an athlete to repeat or continue a performance
otherwise impossible.

Massage is the most economic form of exercise on the
nervous system. Its potency is shown by the increase of
the red-blood corpuscles and hemoglobin, and by the in-
creased rate and force of the heart's beat without a corres-
ponding change in the arterial tension. It accomplishes
these results by decreasing the resistance in the peripheral
vessels, by the removal of the products of oxidation, and
by mechanically moving the blood-current forward in the
lymph-spaces and venous channels. It is thus shown to
stimulate the circulation, the respiration, nutrition, and
excretion.

Mezger describes four principal manipulations: First,
stroking or effleurage, in which the hand is passed lightly
over the skin, with the pressure from the periphery to the
center, following the course of the venous circulation, and
the long direction of the muscles from their insertion to
their origin. It may be performed by stroking with the
palm of one or both hands, with the thumb or tips of the
fingers. The two hands are used upon the large fleshy
parts of the thighs and buttocks, the back, chest, and
neck.

Second, Friction. — This is a deep circular movement, per-
formed with the thumbs and tips of the fingers, or by one
hand open or clenched. The products of fatigue collect-
ing in deep muscular tissues are thus thrown into the cir-
culation, the gentle manipulations of stroking carrying
them into the superficial veins. The friction should pro-
ceed in the same direction as the stroking movements.

Third, p&rissage, also described as pinching and
grasping, is performed by picking up the skin and subcu-
taneous tissues between the thumb and fingers, and manip-
ulating it with an amount of force not sufficient to cause
pain. In this procedure the skin moves with the hand of
the operator, and the underlying structures are thus
massaged by it under the pressure of the fingers. The
thumb and fingers are used to reach the individual muscles

PHYSICAL TRAINING THE KEY TO HEALTH 307

and small groups. The movements should proceed from
the periphery toward the center. It is used to improve
muscular nutrition in case of fatigue, in atrophy, in obesity,
and other forms of muscular degeneration.

Fourth, Striking, Tapdtement, or Percussion. — Other
names are clapping, beating, knocking, or hacking. It
has a stimulating action on the skin, superficial nerves,
and vessels. Hacking is performed by the ulnar border
of the hand, and is used along the nerve-trunks.

Fifth, Shaking or Vibration. — Shaking involves move-
ments of the whole body or region to be treated, while
vibration is a lesser motion in which the body or region
remains at rest, while the surface and the structures im-
mediately beneath it are affected.

General massage is best given at an hour midway between
meals, and never immediately after eating. The parts are
at first lubricated with cocoa-butter or vaselin, to avoid
the irritation which may follow the friction of the surface.

The first process of massage is the simple stroking to
empty out the lymph-channels; the next process is directed
to the deeper tissues. This is deep kneading, and skill is
particularly required here. As the result of this, the
muscles are toned up and the nerves are soothed, so that
the total effect is that of sedation, and is followed by the
removal of the fatigue toxins, so that if necessary it will
be possible to undertake work after the massage that would
have been impossible before.

The operator starts with the feet. After both surfaces
of the foot have been well covered, the foot is firmly grasped
and all the natural movements of the toes and ankles are
gone through with. Next the region of the ankle, the leg,
which is treated by circular friction by the fingers, by
deep grasping of the areolar tissues, and, last, by deep
pinching of the larger muscle masses. At brief intervals
upward stroking is given from the ankle to the knee, to
favor the venous flow of blood-currents. The same proc-
ess is gone through with in the case of the hands and arms.
Especial care is next given to the muscles of the loins, back,

308' PERSONAL HYGIENE FOR WOMEN

and neck. The abdomen is then treated. Massage of
this region concludes with deep kneading by the heel of
the hand in the direction of the colon. The chest is manip-
ulated upward, from the sternum along the line of the
pectoral muscles. The face is not usually treated in
general massage, but the sides of the neck are stroked from
above downward, along the course of the internal jugular
veins. Each part operated upon should be carefully
covered as soon as finished.

There is a constant rise of temperature after the treat-
ment, and there should be a rapid improvement in the
tone and reaction of the whole muscular system.

The usual fault in giving massage is that too much is
given at one time; the maximum effect on a part is ob-
tained in five minutes. Another mistake is to employ too
heavy a hand. A patient should never feel bruised or ex-
hausted after the treatment; there should be simply a
pleasant lassitude and feeling of drowsiness.

While massage is not essential for the health, it aids
materially in maintaining good health, but, in order to be
efficient, a skilful masseuse is necessary, as a considerable
amount of manipulative skill is essential, which can only
be acquired by proper training. Massage, especially
when taken in connection with the Turkish bath, is most
valuable to remove weariness of nerves and muscles, as
well as slight aches and pains.

The Balance and Carriage of the Body. — The erect
position of the body is maintained through the exertion
or more or less muscular force. The base of the erect
human body is the soles of the feet; the smaller the base,
the more danger of a fall. The base is the smallest when
one stands on the toes.

The way in which the spinal column is carried by the
pelvis determines the way in which the whole body is
carried. An erect and graceful carriage in standing and
walking is not only desirable from an esthetic point of
view, but it is most essential to good health. Without a
proper development of the chest, it is impossible to»secure

PHYSICAL TRAINING THE KEY TO HEALTH 309

a normal development of the lungs and vigor of the
heart-
It is upon the erectness, suppleness, and strength of the
spinal column that most of the power and grace of the
body depend. In the proper carriage the natural lines
of the spinal column form a graceful and undulating line,
and the body stands erect without any particular effort.

The curves of the spinal column are of great value in
protecting the brain, as they weaken the force of any
shock, which may be caused by striking the bones of the
feet.

Common Defects in the Carriage of the Body. —
Owing to the common faulty position of school children
at their desks, the sedentary occupations of women, and
their lack of physical training curvature of the spine is
very common. A stooping carriage is the most common.
The head is bent forward, the chest is sunken, the back is
round, the shoulder-blades hang outward, the inner edges
standing out like wings, and the abdomen is protuberant.
The muscles are poorly developed and are weak and
flabby.

This stooping carriage interferes with the freedom in
breathing, and prevents the proper development of the
upper part of the chest and lungs. Hence, it predisposes to
lung diseases and tuberculosis, a weak heart, poor circu-
lation, shortness of breath, inability to take proper exer-
cise, and thinness of the blood (anemia).

Spinal Curvatures. — The spinal column is normally
directly in the middle of the back; any deviation of this
column to either side is abnormal, and the lungs become
cramped in a small and non-distensible bony cage. This
spinal curvature is most apt to take place in young girls
or in adult women after a severe illness, when the muscles
of the back have become particularly flabby, and, while
still in this condition, improper attitudes are assumed at
the desk or other sedentary occupations.

Preventive measures are of the utmost importance.
First of all, comes the general strengthening of the body,

310 PERSONAL HYGIENE FOR WOMEN

and of the muscles and bones in particular, by plenty of
exercise in the open air.

The habitual attitude at the desk and work should al-
ways be carefully observed, and in all sedentary occupa-
tions the work should be frequently interrupted to take
systematic breathing exercises before an open window.

Where spinal curvature has actually taken place, es-
pecial exercises must be taken under the supervision of a
physician and instructor. Gymnastic exercises must be
supplemented by outdoor games and sports.

The Heart's Need of Exercise. — The first essential for
the maintenance of health, capacity for work, and power
of resistance of disease is a normally developed and strong
heart. First, there must be secured a vigorous circulation
of the blood, and the two greatest helps to this are exercise
and deep breathing. In the sedentary posture the heart
works at a disadvantage.

For the young, exercise of the heart is the chief object
of physical exercises; this object is best attained by ex-
ercises of speed, especially in the form of games which
require rapid movement. In youth the recuperative
powers of the heart and lungs are at the highest.

An adult cannot race and scamper about like a child
who plays for hours together, and a disturbance of the
heart's action brought about by strenuous exercise to the
point of fatigue of the heart is not so quickly compensated.
On the other hand, severe exercises of strength and endur-
ance are not so apt to prove injurious after the completion
of growth as they are in the growing youth. Up to the
age of eighteen years no feats of strength or of endurance
should be attempted. From eighteen to thirty years is
the period of life when any kind of athletic exercise can be
taken, not only without any injurious, but with beneficial,
results. After the period of youth new conditions begin
to make themselves felt, and more care must be exercised
in the demands made upon the heart. In some persons
obesity sets in before they have reached thirty and im-
pedes the action of the heart. About the fortieth year the

PHYSICAL TRAINING THE KEY TO HEALTH 311

walls of the arteries begin to lose their elasticity, they
become more rigid, and chalk salts are deposited in them.
Golf and lawn-tennis are now excellent.

And now it is most essential that exercise be kept up;
the heart must still be trained and practised. The fibers
of every muscle degenerates when their work is reduced to
a minimum.

Proper health without proper breathing is a physical
impossibility. It is necessary that those portions of the
lungs which do take part in ordinary breathing, and
which would atrophy from lack of use, should be fully
developed and kept ready for suitable exercise. As soon
as the lungs grow weary and the power of breathing is
exhausted, the most powerful muscles of the body give
way. The pleasure of vigorous walking, especially in
mountainous places, is alone for her who can respond
easily and readily to the enormously increased demands on
the power of the respiration.

The direct result of exercise is an increased demand for
oxygen by the tissues, and, to meet this demand, respira-
tion is deepened and quickened, and the beat of the heart
is more rapid and more forcible. But the phenomena of
increased breathing power and increased heart action
benefit other parts of the body. At the commencement
of an exercise the contraction of the voluntary muscles
called into action compresses the blood-vessels, and im-
pels the venous blood actively toward the heart, which,
thus stimulated, contracts vigorously, and propels the
blood in increased quantity toward the lungs. Stimulated
by the pressure of a large amount of venous blood, the in-
spiratory muscles contract and elevate the bony structure
of the chest, the diaphragm pushes down the abdominal
contents, and the air rushes in to fill the vacuum thus
produced and to supply the oxygen necessary for the puri-
fication of the blood. Supplied with this life-giving
element, the blood is returned to the heart, to be distrib-
uted again throughout the system, and to restore the loss
incurred in the original muscular movements.

312 PERSONAL HYGIENE FOR WOMEN

In this manner are not only the voluntary muscles en-
larged and strengthened, but also the involuntary muscles,
particularly the heart and the diaphragm. The increased
activity of the circulation stimulates other organs to in-
creased activity. The quantity of perspiration from the
skin is more than doubled, the appetite is increased, diges-
tion is more perfect, absorption is more rapid, the hepatic
circulation is more active, and the abdominal circulation is
carried on more vigorously.

But, on the other hand, actual harm may be done if
any one who has been accustomed to lead a sedentary life,
or who is not vigorous, suddenly engages in the more
violent forms of exercise. In this extreme exertion the
heart may be embarrassed by the respiratory action.
At the end of deep inspiration the increased pressure of the
lungs impedes the flow of blood from the right side of the
heart, while the compression of the heart itself by the
distended lungs tends to overfill the large veins, and to
further endanger the right side of the heart.

During general muscular contraction the arterial pres-
sure is increased at the outset of exertion, before the
arteries have become relaxed, and this in turn may lead
to the engorgement of the left side of the heart and -the
circulation through the lungs. To these conditions may
be added still another; that is, the exhaustion of the
respiratory muscles, partly because of the unusual amount
of labor thrown upon them, and partly from the inade-
quate supply of properly oxygenated blood. If the dis-
turbance of the pulmonocardiac equilibrium be severe
and the condition unrelieved, general prostration ensues
long before the muscles engaged in the work are exhausted.
If, on the other hand, the equilibrium be restored, or when
the heart and lungs have been trained to accomplish the
restitution, the distress disappears, and the individual is
said to have gotten his second wind.

The Gymnasium in the Campaign against Disease.
— Women, generally speaking, do not take sufficient exer-
cise. The trend of the present day is for girls of the richer

PHYSICAL TRAINING THE KEY TO HEALTH 313

classes to lead an outdoor life, but the women of the
middle and lower classes do not obtain enough variety
of exercise or enough fresh air, and to the lack of proper
outdoor exercise is due their anemic condition, pallor,
flabby muscles, and generally ill-nourished appearance.

With the division of labor and the increase of wealth it
has become possible for a large proportion of the com-
munity to live without much all-round mental or physical
activity. As a consequence, there are faulty circulation and
defective nutrition, the vital resistance of the body is
lowered, and some of its various organs or tissues are ever
ready to take on disease. The lowering of the tone of the
body through dissipation, want of fresh ail and sunshine,
insufficient sleep, lack of proper occupation or recreation,
also increases the susceptibility of the body to disease.

Senile decay is by no means only a matter of years, but
the manner of life led. And very many people over forty
years of age fall into a condition of senile decay, merely
because they do not take a sufficient amount of active ex-
ercise. In consequence the joints stiffen, the muscles
relax, and the arteries harden prematurely. The prime of
life would be very greatly extended, and old age delayed,
if women only continued their active interest in work and
systematically kept up gymnastic exercises and outdoor
sports.

For all classes of women provision must be made, and
sufficient time afforded, to be devoted to some form of
mental and physical recuperation and systematic physical
training.

Gymnastic versus Athletic Training. — The actual
experience of the past few decades has proved that the
most effective way of developing the mental and physical
powers and the constitutional vigor is through a judicious
system of gymnastics, athletics, and carefully supervised
plays, sports, and games.

To show which of the two contestants was the " better
man " was the primary object of all contests, and this is
the fundamental source of the love of games and athletics.

314 PERSONAL HYGIENE FOR WOMEN

England has relied for her physical training upon a large
variety of games and sports, instead of an elaborate system
of gymnastics. The Englishwomen live an outdoor life,
are great walkers, horseback riders, and go in for athletics
and sports, and we find that the English women have a
much more vigorous physique and healthy and ruddy ap-
pearance than their American sisters.

In Norway, Sweden, Denmark, Finland, France, Ger-
many, and Italy more stress is laid on the gymnastic
training, and in the Olympic contests, held in London in
1908, the twenty-five women from Denmark afforded a
revelation to many of the Americans present.

Medical gymnastics had their origin in Sweden, and are
practised largely in that country and on the Continent.

In gymnastic exercises the work done on each piece of
apparatus must be tried repeatedly, in order to be learned,
and then must be practised assiduously, in order to be
well performed. This is what makes gymnastics so valu-
able as a means of physical training and development.
The first essential is to learn to handle one's own weight,
and to have the muscles of the body under complete con-
trol, and much of the interest and fascination found in
practising heavy gymnastics come from this acquired
power over one's own body, and the ability to make it do
the feats and stunts which one desires it to do. This is
one reason why children love to climb fences, trees, etc.,
and test their ability to handle and master themselves in
new and untried situations.

But, in order that good and not actual harm may be
done, gymnastics must be carried on under medical super-
vision. Bodily exercises should, as far as possible, occupy
the mind at the same time. The fact that gymnastic train-
ing is being taken up in our high-schools and colleges for
girls is a great gain, not only to the individual, but to the
race as well.

The proper development of the body, the clear skin and
eye, the upright and graceful carriage, the free swing of
the body and limbs when they move, give happiness to

PHYSICAL TRAINING THE KEY TO HEALTH 315

the possessor as well as to the onlookers. The esthetic
advantages of health are very considerable.

Among the mental and moral advantages to be derived
from the practice of exercises and games are a greater
amount of self-control, persistence, regularity, prompt-
ness, and of general 'self -confidence. In the playing of
games there is opportunity for originality as well as for
observation. The unwritten code of honor, the need of
accuracy — all these qualities are essential for a successful
and happy issue in the great battle of life.

The ideal physical training requires that systematic
gymnastic exercises should be supplemented by outdoor
games and sports. Gymnastics are not sufficient for an
all-round means of development, because the movements
are too regular, too expected, and too deliberate, but
they are invaluable for health and physical development,
for the correction of physical deformities, as a foundation
for many games and sports, and for supplementing the
same. Many games are so one-sided that gymnastic ex-
ercises are essential to prevent the body from becoming
unsymmetrically developed, and, further, gymnastic ex-
ercises must invariably be the foundation for all games;
no games can do what they are really capable of doing
without the firm foundation of the best gymnastic train-
ing.

Those exercises and games should be selected which are
the most fundamental and the most healthy, which will
cause the all-round development of the body, the muscles,
heart, lungs, chest, a good condition of the blood, good
circulation, breathing, digestion, and the getting rid of
the waste-products.

Such exercises should teach obedience to law, self-con-
trol, regularity, promptitude, and readiness to meet fresh
conditions or emergencies, persistence, pluck, and the
ready cooperation of nerves and muscles.

The aim of gymnastic exercises should be to secure a
symmetric development of all the muscles the body,
to correct one-sidedness, spinal curvatures, and other

316 PERSONAL HYGIENE FOR WOMEN

physical defects, and to strengthen all the muscles of the
body. In the gymnasium especial attention must always
be given to the development and strengthening of the
muscles of the back and chest, as these are the ones that
are apt to be the most poorly developed in women, since
they are less called into play in walking, which is the only
exercise that most women take, and on their good develop-
ment and strength depend the upright carriage of the
body, a good chest capacity, and, hence, good respiratory
capacity, a vigorous heart, and good circulation.

Exercise after Eating. — Severe mental and vigorous
bodily exercise immediately after a meal retards gastric
digestion. The entrance of food into the stomach excites
the free flow of gastric juice, which, like all the secreting
processes, is dependent upon a flux of blood to the secret-
ing glands. Other parts of the body, notably the brain,
suffer from temporary anemia, and hence the great ten-
dency to drowsiness after eating a hearty meal. At such
a time severe mental work or vigorous bodily exercise must
necessarily cause a corresponding withdrawal of blood
from the alimentary canal to the brain, or, in the case of
physical labor, to the extremities, in order to furnish the
amount of blood necessary for the proper performance of
the functions of these parts. The withdrawal of blood
from the digestive organs has the effect of inhibiting gastric
digestion, since there has been an interruption of a free
flow of gastric juice.

We are safe then in believing that digestion is favored
by rest of the stomach before eating, by gentle exercise
of the mind and body after eating, and by an undisturbed
mental condition.

An athletic training is productive of a more complete
oxidation of the nitrogenous materials of the body, and,
therefore, of a more economic utilization of these sub-
stances. In those cases in which there is lack of physical
training, sudden muscular exertion is followed by a waste
of nitrogenous matter.

The Effect of Brain Fatigue on Body Fatigue and

PHYSICAL TRAINING THE KEY TO HEALTH 317

Vice Versa. — Brain fatigue makes the sense of touch less
delicate. Similarly, muscle fatigue affects brain power;
severe muscular exertion may bring a disinclination and
incapacity for brain work. Hard exercise uses up nerve
force, and also causes the circulation of waste-products in
the blood, and so the action of the brain is hindered. On
the other hand, many people who do a great deal of brain
work know that an early morning walk, a pull on the river,
is most refreshing and stimulating, and actually makes
them more capable of doing good brain work; that is, if
they are in fair training and do not take enough exercise
to make them tired.

It is beyond question that a dull gymnastic drill, com-
ing after hours of hard school work, may be a very heavy
tax on the brain and nerves, and can hardly be a relaxa-
tion! Outdoor exercises, which require practically no
brain work and a good deal of muscular exercise, would
do good, such as walking, running, jumping, and various
kinds of games; while, on the contrary, exercises of skill
would be a serious tax.

The suggestion has been widely accepted, that brain
work should occupy the morning hours, while technical
education, such as singing, drawing, and physical training,
should be given in the afternoon.

Marks for Physical Efficiency.— The tests suggested
some fifteen years ago by Sir Francis Galton, the eminent
English scientist, for assigning marks for physical qualifi-
cations were the following: First, breathing capacity;
second, strength tests, both of them to be regarded with
reference to the stature and the weight; third, quickness
of response to a signal, made either to the eye or ear;
fourth, keenness of eye-sight; fifth, keenness of hearing;
sixth, color sense.

Dr. Sargent, realizing the usefulness of these tests in
measuring physical efficiency, included them in the phy-
sical examinations of the Harvard students. The strength
tests consist in the strength of each forearm, of the back of
the legs, the dip, the pull up, and the lung capacity. The

318 PERSONAL HYGIENE FOR WOMEN

combination of these seven tests is known as the inter-
collegiate strength test, and is the best means as yet de-
vised for measuring the general muscular strength and the
respiratory power.

The Advantages Derived from Athletic Sports. —
Nothing can take the place of athletic sports to develop
strong vigorous bodies in girls and young women. While
formal gymnastics have both an educational and correct-
ive value, and lay the foundation for athletic sports, they
cannot take the place of outdoor sports to develop organic
vigor, physical and moral courage, self-reliance, judg-
ment, self-control, decision, and ethical training, a consid-
eration for the rights of others, and a relaxation, particu-
larly from mental work. Athletics are to youth what play
is to children. Groos tells us that a function of play is to
furnish an outlet for exuberance and animal spirits hi the
young.

The Ethical Value of Sports for Women. — First
come the benefits to the individual and second the bene-
fits to the community, and it is a self-evident fact that
that which promotes the highest development of the in-
dividual raises the standard of the community.

The benefits accruing to the individual are physical,
esthetic, and psychologic; and as the result of the de-
velopment of the individual along these lines will result
the fourth benefit, the social or the "community good."

Municipal governments are beginning to recognize the
fact that the maintenance of public playgrounds not
merely promote the good of the individual, but lessen the
death-rate, the poverty rate, the criminal rate, and it has
been found that the working capacity of the people depend
in some way upon the recreation afforded them.

Sports for women are essential, not only to better fit
the individual for her place in life, but as an offset to the
deadly monotony of her work. The predominating note
of sports should be joy, exhilaration, and the social fea-
tures of games.

Women's sports, like women's clubs, are and should be

PHYSICAL TRAINING THE KEY TO HEALTH 319

run along different lines from men's. The object of women's
games are for their development and individual good, and
should, therefore, never be played before indiscriminate
audiences who pay an admission fee.

Women have the same necessity as children and men for
a wholesome physical outlet for the exuberance of animal
spirits and energy.

The esthetic value of games has been found to be ex-
pressed in the improvement of the personal habits and
appearance, which indicates a higher standard of living.

And the psychologic value has been found to be a
development of the mental and the moral qualities, and so
the individual is the better enabled to direct her efforts
wisely and so more successfully in life's activities.

All of this is not a matter of theory, but it is the uni-
versal testimony of the directors of the various athletic
associations for women all over the country.

Among other developments along the physical line are
endurance, skill, precision, and coordination. To be able
to do physical things well has an ethical value in the indi-
vidual's attitude toward life in all its phases.

The esthetic value lays stress upon the beauty and good
form of games. It is essential in playing games that
women should stand well, walk well, run well, throw well,
and have a neat appearance. The manners and habits
of the players on the field are also part of the esthetic
training.

It has also been noted that for reasons largely beyond
her control the primitive occupations of women have been
taken out of her hands, and have forced her, in order to
secure a maintenance for herself, or those depending on
her for support, out of the home into the industries and
occupations of the world, together with a fierce competi-
tion which this necessitates. In other words, success is
based upon competition, and competition is the keynote
of organized games. So that one of the values of games is
to maintain fair, economic, and cooperative rules of com-
petition. Other things being equal, the athletic man or

320 PERSONAL HYGIENE FOR WOMEN

woman who has played according to the rules of the games
is likely to be fairer than he who knows nothing of clean
sport.

Some of the mental qualities developed are observation,
attention, concentration, memory, imagination, initiative,
reason, and will power. These qualities are most highly
developed in the various ball games, from its simplest
forms to team work, as baseball and basket-ball.

The moral qualities developed are self-control, unselfish-
ness, a sense of honor, self-sacrifice, self-confidence, fair-
ness, democracy of spirit, modesty, and decision. One
of the qualities which characterizes a good player is that
she will do the things which are assigned her. Prompt-
ness and obedience to order are the first laws in any game.
Throughout the game self-confidence is taught. Each
player has her own responsibilities, decisions must be
quickly and accurately made, while overconfidence brings
a sure defeat.

If competition underlies all games, it is equally true that
unselfishness is the basis of all team work. The ability
to work together requires at every point unselfish adjust-
ment. One of the first things learned is to appreciate
another's ability, and the individual egotism, so marked
in the beginning of the work, is rapidly toned down.

Closely allied with unselfishness is the spirit of fair play,
and closely linked with fairness is loyalty and a sense of
honor, the lack of which makes girls the contempt of boys
and women the despair of men. It has been averred that
the social position of woman and her dependence upon her
lord and master have lead her to become indirect and
devious, hence her lack of perfect truthfulness and sense
of honor, so that when put upon her honor she does not
realize her responsibility.

Another great advantage that games possess for women
is that many of them, from their weak physical condition,
are abnormally sensitive and introspective; they live too
much on the subjective side of life. While sports are pri-
marily objective, they afford no opportunity for analysis

PHYSICAL TRAINING THE KEY TO HEALTH 321

of feeling; the thought must be riveted on the thing to be
done. Every girl's school and woman's club which pro-
vides opportunities for games and sports erect barriers
against nervousness, morbidity, and too much introspec-
tion. These qualities which games develop are not mas-
culine, but human; qualities needed for human fellowship.

The Forms of Athletic Games Best Suited to
Women. — Dr. Sargent's conclusions as to the form of
athletic games best suited to women, coming from a man
of his wide observation and great experience, should be
more generally known, and he says, without hesitation,
that there is no athletic sport practised in which some
women cannot enter, not only without fear of injury, but
with great prospect of success. But the feminine type
of build, whether found in men or women, is a handicap
in many athletic contests. But these limitations do not
apply to girls between ten and fourteen years of age.
During this period girls, if properly trained, will often sur-
pass boys of the same age in any kind of athletic per-
formance. Moreover, if girls were given the same kind of
physical training as boys receive all through their growing
and developing period, they would be able to make a much
more creditable showing as athletes when they became
adult women. In the early history of mankind the men
and women lead lives more nearly alike, and were conse-
quently more alike physically and mentally than they
have become subsequently in the history of highly civil-
ized people.

From a physiologic standpoint, woman needs exercise
just as much as man does, but, in taking up athletics,
these must be regulated on a different basis. Women, as
a class, cannot stand prolonged physical or mental strain
as well as men do, but give them frequent intervals of rest
and relaxation, and they will often accomplish as much
in the twenty-four hours as men do.

From her physical configuration and her inability to
bear prolonged physical and mental strain, there are
certain athletic sports and games that would be likely

21

322 PERSONAL HYGIENE FOR WOMEN

to prove injurious to most women if played in the form in
which they are played by men. In this group are foot-
ball, ice hockey, polo, basket-ball, boxing, fencing, pole
vaulting, and heavy gymnastics. If these sports and
games should be so modified as to meet the peculiar char-
acteristics of women, there are none of them that could
not be played with reasonable hopes of physical, mental,
and moral improvement.

The athletic exercises and games to which women are
best adapted, and in which they are most likely to excel,
are all forms of dancing, calisthenics and light gymnastics,
archery, lawn-tennis, swimming, field hockey, lacrosse,
sprint running, bicycling, rowing, canoeing, golf, skating,
fencing, basket-ball, and all gymnastic plays and games.

In all athletic exercises in which women engage, good
form, rather than great records, should be striven for.
Women may be excused for not being as strong and en-
during as men, but they cannot be excused for not being
more finished and graceful. Good carriage, perfect poise,
self-command, and exquisite grace and refinement should
enter into women's athletic performances, and these
qualities should be taken into consideration by the judges
in making their awards.

CHAPTER X

SYMMETRIC DEVELOPMENT: GOOD CARRIAGE
AND GRACE OF MOTION THROUGH GYMNAS-
TICS AND ATHLETICS

Gymnasiums, Baths, and Athletic Association: a Fundamental
Part of a Woman's College and a Model Woman's Club; the Vassar
College Gymnasium; the Standardized Percentage Table for Phys-
ical Efficiency; Special Medical Blank for Women; Self-made Good
Physique through Physical Training; Rules for Taking Exercise;
Gymnastic Dress; the Configuration of the Foot; Correct Attitude
in Standing.

Corrective Exercises: Exercises for Developing the Various
Regions of the Body; Shoulder-blade Exercises; Respiratory Exer-
cises; Exercise for Forward Projection of Chest and Retraction of
Abdomen; Shoulder and Back Exercises; Leg Exercises; Squatting
Exercises for Muscles of Spine and Abdomen; Alternate Kneeling;
Abdominal Exercises; Balancing Exercises for Poise and Carriage;
Balancing Exercises for Extending Depth of Chest; Lateral Trunk
and Waist Exercises; Exercises for Muscles of Back; Exercises for
Muscles of Abdomen; Swimming Exercises, for Back, Thighs, and
Abdomen; Rope Pulling-exercises for Back, Chest, Waist, Legs,
and Arms; Exercises in Trunk Flexions for Back, Abdomen, and
Legs; Exercises with Chest Weights for Chest, Shoulders, and Arms;
Boxing and Fencing; Classic and Esthetic Dancing an Essential
Feature in Physical Training; Figures of the Dance with Some
Simple Exercises.

Outdoor Exercises: Effect of Walking on the Heart and Lungs;
Running; Mountain Climbing; Swimming; Horseback Riding as an
Exercise; Rowing.

Athletic Sporta: Croquet; Lawn-tennis; Golf; Hockey; Basket-
ball.

Gymnasiums, Baths, and Athletic Associations
a Fundamental Part of a Woman's College and a
Model Woman's Club. — It has been repeatedly and con-
clusively proved, in a large series of cases, that the phy-
sique, carriage, and health of woman can be wonderfully
improved by regular and systematic gymnastic exercises,
combined with outdoor exercise and athletic sports.

323

324 PERSONAL HYGIENE FOR WOMEN

Briefly stated, the facts in the matter are these : the bony
and the muscular systems and the vital organs are the same
in both men and women, and hence the general scheme of
physical training, which has been found to be so highly
beneficial to men, would, if properly modified, be equally
beneficial to women, and such a training for women is
urged by the most competent authorities of the day.

Two-thirds of the body weight consists of bones and
muscles, and the development, growth, nutrition, and vigor
of the muscular and bony system can only be maintained
by such exercises as will call into play the action of all of
the muscles of the body, that is, the stature, breadth of
shoulders, and size of the chest, as well as firm, hard
muscles, are dependent on regular and systematic exer-
cises of every part of the body, and through the beneficial
effects produced through exercise on the respiration, cir-
culation, and digestion, etc., the brain, nerves, heart,
lungs, in short, all the organs and tissues of the body, are
kept in a healthy condition.

The life of the masses of women to-day is being spent
under artificial and the most unhealthy conditions; for
the most part in overheated, ill-ventilated houses, with
very little time spent in the open air, and without any
knowledge or practice in games and outdoor sports.

The occupation, or lack of occupation, of the majority
of women scarcely calls into play the muscles of the upper
part of the body. This lack of use of the muscles about
the shoulders and upper part of the chest is fatal to the
development of the chest and lungs.

Outside of housewives and domestics, the majority of
professional, business, and working women live under a
very high nervous tension, with but a very slight range of
physical activity. What they all need is a sufficient variety
of exercises to call into play all the muscles and the vari-
ous regions of the body, together with plenty of fresh air,
amusements, and recreations. And already some of our
large, wide-awake, manufacturing establishments, con-
vinced that the practical application of these truths in

SYMMETRIC DEVELOPMENT 325

their own factories would both improve the health of their
employees and be to the financial interest of the firm,
are now providing well-equipped gymnasiums, under the
direction of competent instructors, furnished with baths,
resting-rooms, restaurants, etc., for their employees, and
these experiments have demonstrated that the improved
quantity and quality of the work, the lessened amount of
sickness among the employees, more than compensate
the employers for the expenditure of money and the time
consumed in physical recreation.

It is only within the past decade that the great benefits
to be derived from a systematic, gymnastic training,
combined with athletic sports for girls and women, has
been generally recognized. To-day all our best colleges
for girls and young women have well-equipped gym-
nasiums, with a corps of competent instructors, where a
scientific and systematic course in physical training is
given during the winter months, supplemented during the
fall and spring months by outdoor athletics and games.
And, further, this course is obligatory during the fresh-
man, sophomore, and junior years.

The result of the gymnastic and athletic work done
at Vassar College for the past fifteen years shows a very
great improvement in the physical development, the lung
capacity, and the general health of the students. The
average lung capacity for women is given as one hundred
and fifty cubic inches; at Vassar the average lung capacity
is one hundred and sixty-five cubic inches.

The Vassar College Gymnasium. — As Vassar College
has a model gymnasium, an unusually fine corps of in-
structors, and gives the greatest attention to all the
details of the physical training of its students, it may
very properly serve as a model for schools and women's
clubs throughout the country.

The instructors all received their training at the Sar-
gent Normal School, Cambridge, under the direction of
Dr. Dudley A. Sargent. Hence, it is naturally run along
the same lines.

326 PERSONAL HYGIENE FOR WOMEN

Gymnasium work is carried on from the middle of
November until the end of March. The gymnasium is
furnished with the usual apparatus for light and heavy
work. The entire student body is divided into four
classes; each class meets three times a week, and the period
of work in the gymnasium lasts forty-five minutes. This
is followed by the shower and needle baths.

The wands and dumb-bells used are wooden ones, and
vary in weight from three-fourths of a pound to two and a
half pounds. Other apparatus that might be used in the
home gymnasium are the chest-weights and the rowing
machine with a movable seat.

Instruction in classic dancing is part of the regular gym-
nastic work.

The Vassar gymnasium is also furnished with a fine
swimming pool. The temperature of the water is kept
at from 75° to 80° F. For beginners it is necessary to
have a much higher temperature than for expert swimmers.
Women will be greatly encouraged to learn to swim from
the fact of the incredibly short time in which the art is
taught here. Students learn to swim well in ten lessons
of fifteen minutes each, and the great popularity of these
lessons renders it necessary to limit the instruction to. ten
lessons. Later in the season, if there is space in the pool,
the lessons may be resumed.

Before entering the gymnasium the girl is first of all
carefully examined by the resident physician and gym-
nasium director, and the results of these examinations
recorded.

A detailed series of measurements and strength tests
is made and recorded on the gymnasium register. On
completing the tests, the following card is filled out and
given to each girl. It has been found that these cards,
kept by the girls, increase the interest of each in her
development, and stimulate her to further exertion to
improve her physique.

PLATE VIII

SYMMETRIC DEVELOPMENT

327

VASSAR COLLEGE GYMNASIUM.— RECORD OF PHYSICAL
MEASUREMENTS

MlM*

EXAMINATIONS

Pint.

Second.

Third.

Fourth

Fifth.

Height

Centimeters.

Weight

Pounds.

Lung capacity ....

Cubic inches.

Girth, cheat

Centimeters.

Girth, cheat, full ...

"

Girth, cheet, ninth rib.

»

Girth, cheat, ninth rib,
full

H

Strength, back ....

Kilos.

Strength, legs

«

Strength, cheat ....

.

»

Strength, right forearm

»

Strength, left forearm.

»

The instruments needed for making these tests are the
spirometer and two dynamometers, one to test the strength
of the muscles of the back and legs and the other to test
the muscles of the arms.

Outdoor sports and athletics are begun in the fall, on
the opening of the college, and are continued as long as the
weather permits. The students then take up the regular
gymnastic work until the spring of the year, when athletics
are again resumed. Here again three hours a week are
obligatory. It should be stated here that during the
menstrual period the girls are not only excused from gym-
nastics and athletics, but absolutely forbidden to take
part in these exercises.

The list of games include croquet, lawn-tennis, hockey,
and basket-ball. Rowing has always been a favorite

328 PERSONAL HYGIENE FOB WOMEN

out-door sport at Vassar. In 1909 horseback riding was
again taken up; riding lessons were begun in April, and
two hundred girls took lessons. With the exception of
about twenty, they all rode astride. An ordinary man's
saddle can be used, but a somewhat narrower saddle, with
a higher front, is more comfortable.

The Standardized Percentage Table for Physical Effi-
ciency.— The great importance of heredity on the life his-
tory of the individual is now so generally recognized that
its record becomes almost as important as that of the
woman herself.

The attention of medical examiners is called to the fact
that more stress must be laid upon the habits of dress in
women as a frequently predisposing cause of impaired
physical weakness and tendency to disease. This is em-
phatically so in the case of high French heels and insuffi-
cient clothing. About 75 per cent, of the women of to-
day wear excessively high heels, and quite that number
take practically no exercise.

Because of the great variation in the height of the heel
of the shoe, from 1 to 3 inches, it is essential that the height
should be taken in the stocking feet; and since the weight
of the clothing varies at the different seasons of the year,
the weight should be taken with a minimum amount of
clothing on. While the chest measurements should be
taken with a steel tape with all of the clothing of the chest
removed ; care being taken that the tape does not slip down
in the back.

Difference of pulse in the horizontal and vertical posi-
tions should not exceed 15 beats; and in strong hearts the
rate is just the same.

For the proper completion of this examination it is
most essential that all of the endurance tests should be
made.

Hopping Test. — Heart is counted with the stethoscope
at apex during four consecutive 15-second periods im-
mediately after hopping. Note per cent, of increase from

SYMMETRIC DEVELOPMENT 329

normal during first 15-second period; second, per cent, of
recovery from first 15-second period to fourth 15-second
period.

The ratings are as follows: I. For good heredity, personal
history, and good present condition, 10 per cent.; II.
Normal condition of heart and circulatory system, 10 per
cent.; III. Normal conditions of lungs and chest develop-
ment, 10 per cent. ; IV. Good condition of digestive system
10 per cent. ; V. Normal condition of kidneys, 10 per cent.

VI. Normal condition of nervous system, 10 per cent.

VII. Normal condition of generative organs, 10 per cent.
Normal condition of muscular system, 10 per cent.
Tests of endurance, normal, 5 per cent.; Normal ocu-
lar and aural tests, 5 per cent.; Normal working effi-
ciency, 10 per cent. Making for the normal total of
physical efficiency 100 per cent.

No applicant should be passed who falls below 7.5 per
cent, in any one group of tests, or who falls below 75 per
cent, on the entire examination.

This medical blank was made to gauge as accurately as
possible the physical condition of women, on which their
working efficiency depends. While we cannot measure the
strength and adaptability of the heart and blood-vessels
with the same degree of accuracy as height, weight, and
cheast measurements, yet with the physical examination
and the tests of endurance we can make a very fair esti-
mate. And we are entirely dependent for the history of
heredity, personal history, and that of the digestive and
nervous systems upon the woman herself; but the history
of the present condition at least can be to a great extent
verified or annulled by the physical examination and by the
present condition.

By the quickness and conciseness with which the ques-
tions are answered; the woman's posture when she does not
realize that it is being studied ; her movements as she goes
from one test to another and the way she conducts herself
throughout this very rigid physical examination, which

330 PERSONAL HYGIENE FOR WOMEN

working under high pressure with the aid of a stenographer
and office nurse, takes one hour to complete; one can judge
pretty accurately of her working efficiency.

The applicants should be graded into four classes:

Class A. Those having an excellent record in all tests.

Class B. Those having a good average record and no
poor record in any test.

Class C. Those having a fair average record and who
are free from organic defects.

Class D. Those having some definite organic disease
which, in the judgment of the examiner, would make it
dangerous for the individual to undertake any confining or
laborious occupation.

Only those who come under Class "A" or "B" should be
recommended for any confining or laborious occupation.
By suitable methods for the correction of faulty habits of
hygiene and systematic physical training for one year
those in Class "C" should be able to gain admittance to
one of the first two classes.

To be most beneficial to the candidate, after the physical
examination is completed, there should follow a brief
personal talk, making suggestions for the correction of
faulty personal hygiene; and where medical treatment is
indicated, instructions to place herself under the care of a
physician. This has from the first been the policy of the
board and of the medical examiner.

And on their part, the candidates are now beginning to
thoroughly realize that these examinations are decidedly
to their advantage and regard them as a privilege to which
they are entitled. And the majority of them go out with
the determination to get and keep well and strong.

SPECIAL MEDICAL BLANK FOR WOMEN

Report of Medical Examiner

In the case of
Address,

Place of birth,
Age, Occupation,

SYMMETRIC DEVELOPMENT 331

I. Heredity: Adverse Family History.
Tuberculosis?

Insanity or tendency to nervous exhaustion?
Cancer?
Heart disease?
Kidney disease?

Personal History.

Acute diseases since childhood?

Number of days lost in past year through illness?

Notable increase or decrease of weight during the past year?

Present Condition.

Nutrition, color, and condition of skin?
General appearance, as indicative of health?
Dress: Habits of: 1 inch heels?

II. Heart and Circulatory System.
Temperature?

Size of heart? Force of apex-beat?

Murmurs?

Blood-pressure: Maximal? Minimal?

Pulse at rest? Horizontal? Vertical? After strength tests?
Pulse, Character: Normal? Intermittent?

Irregular? Unequal?

Blood examination. —
Absence of varicose veins and hemorrhoids?

III. Lungs and Chest Development.

Respiration: Frequency? Normal? Shallow? Deep?

Auscultation? Adventitious sounds?

Girth of chest: Repose? Forced insp'n? Forced exp'n?

Ninth rib: Repose? Forced insp'n? Forced exp'n?

Normal, hi relation to height?

Depth of chest: Repose? Forced insp'n? Forced exp'n?
Lung capacity, measured by spirometer?
Girth of waist?

Nose: Normal? Obstructed?

Throat: Normal? Catarrh? Tonsils: R.? L.?

IV. Digestive System.

Teeth: Good? Fair? Poor?

Tongue: Clean? Coated? Pale?

Breath?

Functional derangement of stomach?
" " intestines?

" liver?

Normal size of liver and absence of tenderness?
Normal size and position of stomach and intestines?
Regularity of stools with normal color and consistence?
Constipation? Diarrhea?

Appendicitis?

332 PERSONAL HYGIENE FOR WOMEN

V. The Kidneys.

Quantity of urine for twenty-four hours?

Frequency of urination?

Specific gravity and reaction?

Indican?

Albumin?

Sugar?

Casts?

Position of kidneys?

VI. The Nervous System.

Tendency to headache?

Character of "

Pain or tenderness of spinal cord?

Number of hours that can now be spent in study daily?

Tendency to nervous exhaustion?

Character of sleep: Insomnia?

Mental poise?

VII. Generative Organs.

Position and size of uterus?

Inflammation of uterus?

Position and size of ovaries?

Inflammation of ovaries?

Menstrual flow: Quantity? Frequency?

Pain: Before? During flow? Length of time?

Vaginal discharge?

VIII. The Muscular System.

Height? Weight? Normal?

Stretch of arms? Breadth of shoulders? Breadth of hips?

Posture: Sitting? Standing? Walking?

Figure?

Shoulders: Round? Sloping? Scapula prominent?

Spine? Lateral curvature?

Abdomen: Normal? Protuberant?

Feet: Weak ankle : R.? L.? Weak arch: R.? L.?

Flat: R.? L.?

Strength of right forearm? Of left forearm?

Strength of back? Strength of legs?

Strength of upper arms (push up)?
Strength of upper arms (pull up)?

IX. Tests of Endurance.

How long a time is spent daily in physical exercise?

What form?

What is the average rate of speed in walking?

Does hill climbing cause shortness of breath?

What out-door sports are practised?

Length of time required for test walk of three miles?

Pulse before? After?

Heart reaction to exercise: Hopping 100 feet?

SYMMETRIC DEVELOPMENT 333

Ocular Tests.

Distant vision : Right? Left?

Astigmatism?

Aural Tests.

• X. General Impression of Working Efficiency.
Temperament?
Personality?
Self-control?
Initiative?
Capability?

Suggestions for Faulty Personal Hygiene.

Indications for Medical Treatment

Remarks.

Signature of Medical Examiner, , M. D.

Address,
Date,

Self-made Good Physique Through Physical Train-
ing.— It has not infrequently happened that, by outdoor
life and physical training, young men and women of frail
constitutions have developed into strong, robust, and even
physically powerful men and women.

While membership in a well-appointed gymnasium and
athletic association offers the most favorable conditions
for the symmetric and fullest development of the body,
and when possible it is advised always to take at least a
short course in physical training under the direction of a
competent instructor, yet every woman has it in her power
to very greatly improve her physical condition without
these aids.

Systematic physical training should be begun in child-
hood and continued all through life.

Before twelve years of age physical training should be
the same for both sexes, and girls and boys should have
their sports and games together. The beneficial influence
of this will be manifest for both — girls will grow stronger,
less timid, and more resourceful, and boys will grow more
refined and thoughtful.

But even the case of the adult woman, where not only

334 PERSONAL HYGIENE FOR WOMEN

physical training but most of the laws of health have been
neglected, is far from hopeless. A poorly developed chest,
round shoulders, a beginning spinal curvature, a poor car-
riage, bad skin, poor circulation, indigestion, constipation,
and low vitality, with poor powers of resistance to changes
in the weather and environment, are not insurmountable
obstacles. But a woman in this condition cannot manage
her own case. She must consult and place herself under
the care of a competent physician.

Two charts should be made out; the first should be a
detailed outline of her present condition; to the Vassar
chart already given should be added the physical defects
needing correction, as round shoulders, poor chest develop-
ment, palpitation of the heart on exertion, length of walk
that can be taken comfortably, also the time required per
mile. As the strength of the heart and lungs increases, as
shown not only by the actual tests, but also by the increased
powers of endurance, this first chart will be a matter of
great encouragement to the woman and a great incentive
to further effort. In a parallel column to the defects should
be written the corrective measure for those defects.
The second chart should contain the ideal measurements
and strength tests for a woman of her height and weight.

Rules for Taking Exercise. — The first things to be
aimed at are the proper ventilation of the lungs, together
with their development, and the strengthening of the
heart. During the exercise the windows must be thrown
wide open, or the very object of the exercise is defeated.

Always begin with the simplest exercises and stop at the
first sign of fatigue. The very first exercise will, therefore,
be the simple respiratory exercises, taken in bed until one
acquires some control of the muscles; they are then taken
standing before a mirror, to insure the exercises being
taken correctly, and after this they should be taken before
an open window. The respiratory should be alternated
with the abdominal exercises, and all of these should be
taken for twenty minutes at a time, at least twice a day,
on rising and immediately before retiring.

Two hours should be spent out-of-doors every day.

SYMMETRIC DEVELOPMENT 335

If the woman is weak and unused to taking exercise, she
should walk until she feels the first signs of fatigue, rest,
and then continue her walk. If the weather is too cold for
sitting out-of-doors the woman should preferably take two
short walks each day, one in the morning and the other in
the afternoon. For invalids about ten in the morning and
two in the afternoon are the best hours in winter, because
of the greater warmth of the sun at those times. To be
effective, exercise out-of-doors must be taken every day
without regard to the weather, since the system, when in a
state of activity, is less susceptible to sudden changes of
temperature than when at rest.

Exercise should not be taken after long fasting; hence,
never before breakfast, nor immediately after a hearty
meal. An hour after breakfast or a light lunch, or two
hours after dinner, is the best time for regular exercise.

A certain amount of daily exercise is essential for the
preservation of the health. A healthy woman should be
able to walk five miles a day, at the rate of three miles an
hour, without feeling any sense of fatigue.

In order to secure the greatest amount of benefit from
exercise, the mind should be entirely free from care during
the exercise, so that the woman should leave her cares at
home and give up her mind and body to recreation while
she is out-of-doors.

Regularity in taking exercise is absolutely essential
to secure good physical development and to maintain the
body hi a condition of health. A fixed hour should be set
aside for this purpose every day.

No definite rules can be given for the exact amount of
exercise to be taken at one time, but the occurrence of
fatigue is the signal for rest; after a five minutes' rest,
exercise may be again resumed, to be stopped again at the
same signal of fatigue. Perhaps three periods of exercise,
alternating with rest, may be taken, but, in order to do
good and not harm, the individual must always stop be-
fore she is tired.

A period of free exercises should begin with a twenty
minutes' practice, including movements for arms, legs,

336 PERSONAL HYGIENE FOR WOMEN

back, chest, and abdomen, with especial emphasis on the
correct poise and carriage of the body and deep breathing,
and it should terminate with running; or, if in a class, with
a running game.

For those of mature age and sedentary habits especial
care must be taken not to overtax the heart, always be-
ginning with the simplest movements and stopping at the
first signs of fatigue.

In the gymnasium the periods of exercise generally
cover forty-five minutes, with frequent intervals of rest
in between. Even here an invariable rule should be never
to exercise to extreme weariness.

All exercise should be followed by a shower or needle
bath, and a vigorous rubbing with or without alcohol.
Very delicate women who have been unaccustomed to tak-
ing exercise should rest on the couch or bed for one hour
before proceeding to dress. It is well to sleep, if possible,
and in this way they will find the good effects of the exer-
cise very greatly increased.

Gymnastic Dress. — The usual and best style of gym-
nastic dress is a bloomer costume, the bloomers coming
above the knees, long stockings, and thin, flat-soled shoes
without any heels. The dress must be loose at the neck
and waist, or it may be cut low in the neck. The sleeves
are preferably short elbow sleeves.

If the exercises are taken at home, the woman may wear
a combination undersuit, with stockings and broad-soled
heelless slippers. The lighter the dress, the better, so that
there shall be no sense of weight or restriction about the
neck, waist, or shoulders.

By putting on her bedroom slippers any one can easily
convince herself of the greater grip the foot has on the floor
when so clad, and of the greater ease and sureness of the
foot in walking.

For outdoor athletics a short skirt, coming just below
the knees, may be worn over the bloomer costume. Ten-
nis shoes should always be worn.

All rooms used for exercise, gymnasiums, .and ball-

SYMMETRIC DEVELOPMENT

27, 2), and the weight of the body is shifted more and
more to the center of the foot and toes, the latter spread-
ing and pushing the body forward. This last is the
movement which displays to the greatest advantage the
suppleness and elasticity of the articulations of the foot,
and the adaptation of the arch to receive the weight of the
body, and to transfer it to the distal pier, while the body
is being moved forward by the same act. It is the exe-

Fig. 27. — The natural and artificial positions of the foot (Camper).

cution of this movement which gives to the gait of woman
that elegance and those graceful undulations which are so
attractive.

"The narrow high-heeled shoe, on the other hand, by
displacing the supporting base, causes both piers of the
double-spanned arch to strike at the ground simultane-
ously. In consequence of which the gait, instead of being
undulating, is stiff and hobbling, and the body advances
by jerks.

340 PERSONAL HYGIENE FOR WOMEN

"When standing on the heel bone (NLM, Fig. 27, 1),
the joint at K, and the great toe C, touch the support
upon the line A-B. When the feet are shod according to
the present fashion, the line A-B is made to assume
the concave form shown in Fig. 27, 3, by BTu. The
instep is made more convex and rounded, and the
foot is actually shortened (see a-b, Fig. 27, 3). The
constant elevation of the heel places the body of the
pedestrian in the same position as when standing upon an
inclined plane. Again, the heel is so shaped and located
that it forces up the keystone of the arch and weakens the
whole structure."

The Correct Attitude in Standing (See Fig. 28).—
The heels are placed nearly together, the toes pointed
very slightly outward, the legs are rigid, the trunk and
head are held erect, and the shoulders somewhat back,
so that the chest shall expand freely. The arms should
hang easily at the sides; the fingers are slightly bent, with
the thumbs in front. This position of "attention" can
only be maintained comfortably for a very short length
of time, since the actively contracting muscles soon
tire.

If the standing position has to be maintained for any
great length of tune, one foot should be placed slightly
in advance of the other, the weight being borne upon the
straight leg and the active supporting foot, the other
being relatively passive. This asymmetric position has
the important advantage that the two extremities may be
brought alternately into play.

The most common defect in standing is that the entire
weight is usually borne upon the same leg, generally the
right one, while the left, being inactive, is placed out to one
side; the habitual maintenance of this position leads, as
we shall see later, to a tilting of the pelvis to one side,
with a consequent spinal curvature and lowering of one
shoulder.

Persons with strong feet, especially primitive unshod
feet, mountaineers, runners, and young children, walk

SYMMETRIC DEVELOPMENT 337

rooms must be thoroughly ventilated before the assem-
blage of the people. The air must be kept cool, between
50° and 60° F., and proper arrangements must be made to
keep the room well ventilated while in use without causing
direct drafts.

Well-waxed, hard-wood floors are the best, because
they can be kept freest from dust. Students should never
be allowed to enter the gymnasium with their street shoes
on, as they carry with them much dust that will be thrown
in motion and inhaled during the performance of the vari-

Mctatarul Bonra.

Fig. 26. — Upper surface, bones of foot (Allen).

ous exercises, and there follows not only the irritation
caused by the inhalation of the particles of dust, but also
the danger of inspiring all kinds of germs of disease with
which the air is laden.

The Configuration of the Foot. — No study of the
correct attitude of the body at rest or in motion would be
complete without some knowledge of the structural ar-
rangement of the foot. The feet form the base of support
for the entire body, and at every step are subjected to a
pressure of from one hundred to two hundred pounds.

m

338 PERSONAL HYGIENE FOR WOMEN

This base is in the form of two arches, a transverse and
an anteroposterior. The latter is the most important, and
has been subdivided into two by an imaginary line, drawn
between the third and fourth metatarsal bones. The inner
portion of this arch is much more curved than the outer,
and forms the instep. The arch is supported by two
piers. The posterior pier is formed by the os calcis, or
heel bone, and the posterior part of the astragulus. It
is shorter, has but one joint, is more curved, and is, at the
same time, more solid than the anterior pier, and receives
the greater part of the weight of the body. The anterior
pier includes all the bones in front of the astragulus to
the junction of the three metatarsal bones with the toes.
It is much the longer, is less curved, and has many joints,
giving it greater elasticity, and also enabling it to diminish
the force of shocks transmitted to the arch. The summit
of the arch is the ankle.

It is evident that the superincumbent pressure, by
flattening the arches, both lengthens and broadens the
foot. The anteroposterior arch is further lengthened by
a turning upward of the toes, which form a hinge-joint
with the instep.

In extension the foot normally rests upon the heel,
the tips of the metatarsal bones, and the outer side of the
sole. In walking, running, or dancing the direction of
the weight upon the arches is constantly changing, and
it is only through the action of certain muscles that the
normal arches are conserved. This healthy condition of
the plantar arch can only be maintained by the evenly
balanced action of those muscles which surround and
strengthen the weak parts of the arch.

Dr. Busey's description of the foot hi walking, and the
injurious effects of the high-heeled shoe, is as follows:
"In walking the heel touches the ground first, and sup-
ports the whole weight of the body for a moment. A little
later the point of the foot touches, and assists in preserv-
ing the equilibrium by increasing the base. During the
second movement of walking the heel is raised (see Fig.

SYMMETRIC DEVELOPMENT 341

with the inner borders of the feet nearly parallel to each
other and the direction of motion. The best sculpture,
both ancient and modern, shows the straight supporting
foot, which in standing is not necessarily parallel with its
mate, since the resting foot may assume almost any angle
of divergence.

The influence of the stability of a correct base is well
illustrated by standing on one foot and swinging the other
leg backward and forward, which is much more difficult if
the supporting foot be turned to one side. A runner finds
it very difficult to run with the toes turned out, although
the heels never touch the ground.

Corrective Exercises. — Many of the most common
defects, such as a drooping head, round shoulders, flat
chest, beginning spinal curvature, etc., result from a
weak and relaxed condition of the muscles, whose function
it is to move and support these parts. If the head is con-
stantly bent forward in studying and writing at the desk,
the muscles at the back of the neck gradually lose their
tone, and stretch out like a piece of elastic that is con-
stantly kept on the strain.

The exercises selected must be such as will strengthen
these particular groups of muscles, and, while taking the
exercises, the entire attention must be concentrated on the
part being exercised.

Any lack of symmetry in the chest, spinal curvature,
or actual weakness of the lungs will necessitate the pre-
scribing of special and carefully selected exercises.

As to the exercises themselves, they should be so
arranged as to bring into play in a methodic manner all
the muscles. All special and corrective work must be
supplemented by general work, which will increase the
organic vigor of the heart, lungs, and chest necessary to
meet the vital demands of the whole system. Games are,
of course, most useful for this purpose, but the games
should not be too violent.

In most free exercises the limbs are used for weights of
resistance. In a man weighing one hundred and fifty

342

PERSONAL HYGIENE FOR WOMEN

ttnital
verUrt*

pounds the arms usually weigh about ten pounds each

and the legs twenty pounds.

The Causes of Round Shoulders.
— The general conditions are those
that produce muscular or constitu-
tional weakness, as rapid growth,
overwork, the impure air of ill-ven-
tilate*d rooms, acute illness, near-
sightedness uncorrected by glasses,
lack of proper exercise, and the
wearing of clothing supported by
suspenders bearing on the points
of the shoulders, tending to pull
them downward and forward, or
even to produce a painful deformity
of the scapula.

It is the rule rather than the ex-
ception to find, with round shoul-
ders, some inequality in the height.
The right shoulder is apt to be the
lower, owing to the carrying of
burdens on the right arm. Habitual
standing with the weight on- the
right leg contributes to a good
many cases. Games in which the
right arm is almost exclusively used
is another cause.

The Causes of Spinal Curvature.
— The spinal column forms the
central support of the body, and,
for grace and suppleness of motion,
its thirty-four joints should be con-
stantly exercised, as well as the
muscles which hold it erect and
support the head upon it, as well
as attach the shoulders, hips, and

legs more or less closely to it. In brief, all the muscles

of the back need varied and regular exercise to maintain

coeyrx

Fig. 29.— The spinal
column (Church and
Peterson).

SYMMETRIC DEVELOPMENT 343

the erect position of the body, and from early child-
hood especial attention should be given to develop and
strengthen this region of the body.

The normal movements of the spinal column are flexion,
extension, side bending, and torsion. Flexion and ex-
tension take place, for the most part, in the lumbar and
cervical regions.

Gould believes that astigmatism is a prominent factor
in the causation of spinal curvature; the curvature is
affected by the tilting of the head to one side in reading
or writing.

But a faulty postural habit is probably the most fre-
quent cause both in standing and at the desk. When the
weight is supported by the right leg, the left being used
merely as a prop; there is a marked C-shaped curve pro-
duced, with a lowering of the right shoulder and promi-
nence of the right hip. This position is assumed by school
children for long periods of time, and there is a consequent
overstretching of the ligaments of the spine and hip.
These cases are generally accompanied by round shoulders
and flat chest, protrusion of the abdomen, and rotation of
the vertebrae.

A muscle can be developed only by the active con-
traction and relaxation of its fibers. Continuous tension
quickly tires and lowers its tone, so that exercises given for
increasing muscular power should be comparatively quick
and frequently repeated, while those that aim at the
stretching of muscles and ligaments should be slow and
long maintained.

In all cases where corrective treatment is needed the
first thing to be attended to is the general condition,
and the best hygienic conditions must be provided,
the general health inquired into and attended to. In
all cases the eyes should be examined by a competent
oculist.

All exercises and stretching movements should be given
daily, with a period of rest after three or four movements,
and they should be so alternated and combined that no

344 PERSONAL HYGIENE FOR WOMEN

two, employing the same muscles in the same way, should
follow one another, and so cause excessive fatigue.

The Muscles of the Abdomen, — These muscles are most
important for breathing and therefore for health, for the
retention in their normal position of the various abdominal
viscera, for good digestion and regularity of the evacua-
tion of the bowels. Sluggish digestion and constipation
are among the commonest evils in life, and they are gen-
erally connected with relaxed abdominal walls and flabbi-
ness of the abdominal muscles. Active pressure of the
abdominal muscles on the viscera massages the liver and
presses onward the contents of the intestines.

The protuberant abdomen may either be due to a faulty
position in standing or an excess of fat in the great omen-
turn, a membrane intended to protect the bowels. This
excess of fat may be hi turn due to lack of exercise or an
excess of sweets and starchy foods, and the reduction of
this superfluous fat by suitable exercises, properly taken,
together with the attention to the diet, not starvation, is
the only common sense and safe way for a woman to reduce
her size.

The abdominal muscles are used in bending, in stooping
forward, in raising up from the recumbent position, some-
what in climbing, and in many other movements. Trunk
bending forward and backward; lateral flexions of the
trunk ; bending of the knees down to a squatting position,
together with torsions, and all exercises derived from these
types, bring into play and exercise the abdominal muscles.

EXERCISES FOR DEVELOPING THE VARIOUS REGIONS
OF THE BODY

The following list of free exercises has been selected
primarily for developing the lungs and chest and correcting
deformities, such as round shoulders, stooping attitude,
and beginning spinal curvature, when due only to muscular
weakness and faulty attitude in standing, sitting, and
walking.

Fig. 28. — Correct attitude in standing.

Fig. 30. — Correct attitude in walking. First position.

Fig. 31. — Correct attitude in walking. Second position.

Fig. 32.— Shoulder-blade exercise. First position.

Fig. 33. — Shoulder-blade exercise. Second position.

SYMMETRIC DEVELOPMENT 345

While each exercise calls into play many other muscles
than the ones for whose development the exercise is given,
the exercise is classed under the group for the region which
it is especially designed to benefit.

Shoulder-blade Exercises (Fig. 32). — First Position.
— Stand erect, with the feet nearly together, and the
palms of the hands brought together above the head in
the manner shown in the figure.

Second Position (Fig. 33) . — Throw hands and forearms
backward, keeping the arms on a line with the shoulders,
the elbows bent, and turn the palms forward, as repre-
sented in the second position of the figure. Return to
the first position, and repeat ten times. These exercises
strengthen particularly the muscles between the shoulder-
blades, whose function it is to hold the shoulders back.

The first point in taking each exercise is to learn the
correct attitude before a mirror; after this has been
mastered, the exercises should be taken with a considerable
amount of rapidity and force, but not so forcibly that the
collar-bone projects at its junction with the breast-bone.
In throwing the hands and forearms back, the force of
the motion should come at the elbows, not at the hands,
and the shoulders should be carried as far back as possible.

Shoulder-blade Exercises, Number 2 (Fig. 34). —
Stand erect, with the feet nearly together, and with
the hands clasped behind the neck, as seen in the
figure. Then force the head and elbows strongly back.
Relax, letting the elbows come forward. Repeat ten
times.

It will be readily seen that these shoulder-blade move-
ments are exercises for the arms and chest as well. The
object being to raise and broaden the chest.

Respiratory Exercises (Figs. 35, 36, 37).— First Posi-
tion.— Stand with the feet nearly together, the chin down,
the arms extended downward, with the backs of the hands
touching, as shown in the figure.

Second Position. — The chin should be raised with the
arms, so that in the second position the head is held erect.

346 PERSONAL HYGIENE FOR WOMEN

Third Position. — The movements of the hands are car-
ried upward still further and separated as shown in the
figure. From this position the hands should be brought
downward in the large sweep of a circle to the original
position.

When these various movements have been accurately
acquired, forcible respiratory movements should be added.
Begin to inhale forcibly as the hands are raised, and hold
the breath as long as possible while the hands are held
above the head, and exhale forcibly while the arms are be-
ing brought down. These exercises bring into play the
muscles of natural and forced respiration.

Exercises for Forward Projection of the Chest and
Retraction of the Abdomen (Figs. 38, 39).— First Posi-
tion.— Stand erect, with the arms behind the back, the
hands resting in the small of the back, the fingers inter-
locked, and the palms facing backward.

Second Position. — Straighten the arms, turn the palms
inward and then downward, and lastly out, all the while
keeping the fingers interlocked. Roll the shoulders and
arms into supination, and extend the neck, as in the atti-
tude of the second position of the figure. Retain this
position for a moment, then reverse slowly back into the
first position.

When the fingers cannot be held in this position, start
by holding a loop of cord in the hands, instead of interlock-
ing the fingers.

This exercise is particularly valuable for projecting the
chest forward, stretching the shortened ligaments, and
drawing in the abdomen. Care should be taken to have
the chin pressed backward when the arms are brought
downward and turned outward.

Shoulder and Back Exercises (Figs. 40, 41).— First Po-
sition.— Stand erect, with the feet together, and both arms
extended on a plane with the shoulders, so that in the first
position the left arm is extended directly in front of the
body and the right arm on the same plane directly behind
the body. The arms must be held rigidly on the same
plane.

Fig. 34. — Shoulder-blade exercise. Number 2.

Fig. 35. — Respiratory exercise. First position.

Fig. 36. — Respiratory exercise. Second position.

Fig. 37. — Respiratory exercixe. Third jKWiition.

Fig. 38. — Exercise for forward projection of chest and retraction
of abdomen. First position.

Fig. 39. — Exercise for forward projection of chest ami retraction of
abdomen. Second position.

Fig. 40. — Shoulder and back exercises. First position.

Fig. 41. — Shoulder ami hack exercises. Second i>osition.

Fig. 42. — Leg exercises. First position.

Fig. 43. — Leg exercises. Second position.

Fig. 44; — Squatting exercises for muscles of spine and abdomen.

SYMMETRIC DEVELOPMENT 347

Second Position. — By a circular movement, the position
of the left arm is assumed by the right, and vice versa.
During the entire movement the feet must be kept firmly
planted on the floor, pivoting at the hips only, while mak-
ing the continuous circular movement of the arms.

These movements consist in a torsion of the body
around the axis of the spinal column, and to these can be
added deep inspirations from left to right, with expira-
tions from right to left. In addition to the effect on the
circulation, the respiratory movements keep up the nu-
trition and efficiency of the lungs, which in old age undergo
a kind of atrophy, and also maintain the elasticity of the
chest-walls, which are apt to become stiff through disuse,
and so interfere with the movements of the lungs and
pleura.

Leg Exercises (Figs. 42, 43). — First Position. — Stand
erect, with the hands resting on the hips and the legs
crossed at the knees, with the right foot in front, as shown
in the figure.

Second Position. — Swing the right leg outward and
around back to about eighteen inches back of the left foot,
as is shown in the second position. Then swing the right
leg outward and around, back to the first position.

Reverse the position of the feet, and perform the same
movements with the left leg. The weight of the body
must always be thrown on the advanced leg, and perfect
poise and balance should be maintained throughout the
entire movement.

Leg exercises are useful for purposes of relieving the
engorged veins of the fatigued leg, because the movements
of such large masses of muscles as those of the legs and
thighs demand large supplies of blood, and consequent
quick action on the part of the heart to supply it, and this
blood, pouring swiftly back to the lungs for purification,
requires frequent and deeper inspirations on their part to
effect the purification ; leg exerciser cause greater develop-
ment of the chest than do arm exercises.

Squatting Exercises for Muscles of the Spine and

348 PERSONAL HYGIENE FOR WOMEN

Abdomen (Fig. 44). — Stand erect, with the feet near
together and the hands resting on the hips, rise upon the
toes, then sink the body to the floor, bending the knees
sharply, until the thighs and legs are doubled upon each
other and the weight of the entire body is supported by
the toes. The trunk must be maintained perfectly erect
throughout the movement. Then return to the original
position. Repeat ten times.

These exercises strengthen the muscles of the spine and
abdomen, and aid in reducing superfluous abdominal
fat. They also strengthen the ankles and increase the
flexibility of the knee-joints.

Alternate Kneeling; Abdominal Exercise (Fig. 45).
— While these exercises also strengthen the muscles of
the spine and legs, they are primarily abdominal exer-
cises, and are given for the strengthening of the abdominal
muscles and improving the circulation in the abdominal
viscera.

First Position. — Kneel on the left knee, with the face
directed forward, the right arm extended perpendicularly
up at the side of the head, and the left hand resting on the
hip. The head and entire trunk are then turned slowly
to the left, the right arm all the while being held rigidly
up at the side of the head, then returns slowly to the
original position.

Second Position. — Kneel on the right knee, with the face
looking directly forward, and the left hand extended above
the head, and the right hand resting on the hip. The head
and entire trunk are then turned slowly toward the right,
and the position maintained for a moment, then return to
the original position. Repeat five times for each leg.

These exercises strengthen the abdominal muscles,
those at the side of the waist, and groins.

Balancing Exercises for Poise and Carriage (Fig.
46). — These exercises, for maintaining the equilibrium of
the body while it is poised upon the smallest possible base,
are among the most difficult positions to maintain, requir-
ing a high degree of coordination of movement. They

'

Fig. 45. — Alternate kneeling; abdominal exercise.

Fig. 46. — Balancing exercise for poise and carriage.

Fig. 47. — Balancing exercise for extending depth of chest. First

position.

Fig. 48. — Balancing exercise for extending depth of chest. Second

jxxsition.

Fig. 49. — Lateral trunk and waist exercise. First position.

r. ">0.— I-Ateral trunk and waist exercise. Second position.

SYMMETRIC DEVELOPMENT 349

are given to improve the poise and carriage of the
body.

The position of the right foot in the figure is incorrect,
since the object of the movement is to have the body
balanced throughout on the toes only. Stand erect on
the tiptoes, with the arms and hands extended at the sides
and above the head, as shown in the figure; then walk
in the same position, with the hands carried up perpendicu-
larly at the sides of the head.

Further benefits in the carriage of the body may be ob-
tained by carrying light weights upon the head while per-
forming these exercises, as a light book.

These exercises, when properly performed, expand the
chest and bring into play all the extensors of the back
and elevators of the shoulders. They also round out the
muscles of the throat and neck.

Balancing Exercises for Extending Depth of Chest
(Figs. 47, 48) . — First Position. — Stand erect, with the heels
together and the hands resting on the hips. Straighten
out the right arm, and extend it perpendicularly up at
the side of the head, and at the same time carry the left
leg outward and upward as far as possible, according to
the pose assumed in the figure. Then lower the leg and
arm, returning to the original position.

Second Position. — Stand erect, with the heels together
and the hands resting on the hips, as in the first position.
Then take the same movements with the left arm and right
leg as were taken in the first position. The arm and leg
should be raised and lowered simultaneously.

All these exercises increase the vertical diameters of
the chest, and strengthen the muscles of ordinary and
forced respiration.

These movements also relieve the engorged veins of
fatigued legs.

Lateral Trunk and Waist Exercises (Figs. 49, 50).—
First Position. — Stand with the feet nearly together and
the arms extended above the head ; the arms are relaxed
at the wrists and elbows, so that a slightly curved line

350 PERSONAL HYGIENE FOR WOMEN

is formed, as is shown in the figure. First sway to the
left, bending at the waist line as far as possible, and re-
turn to the original position.

Second Position. — The attitude is the same as in the
first position; sway to the left in the same manner.

These exercises strengthen the muscles on the sides of
the abdomen and the lower part of the back, and are an
excellent means to reduce the size of the waist in case of
corpulency.

Exercises for the Muscles of the Back (Fig. 51). —
These exercises may be taken lying prone on the floor,
with the feet caught under any piece of furniture which is
strong and low enough to act as a cross-bar, as a lounge
or dressing case. No one but an athlete could take this
exercise without having the feet held down.

The feet should be held firmly down, and the hands may
be at the sides or clasped behind the waist; the body is
then slowly raised and carried backward to the half -sitting
posture, then gradually lowered to the original position.
These movements should be taken slowly and not repeated
more than five times in the beginning.

In case of stooping or round shoulders, the hands
should be clasped at the back of the neck instead of at
the waist.

Raise the head and extend the spine, pressing the
elbows backward. This exercise is a severe one on the
extensors of the back and the rotators of the shoulders.

Exercises for the Muscles of the Abdomen (Fig.
52). — Lie supine on the floor, with the feet firmly fixed
under a cross bar, or a piece of furniture which will answer
this purpose, and the hands resting on the hips, as shown
in the figure; slowly raise the body to the upright posi-
tion, maintain for a moment, and return to the first
position.

This and the preceding exercise are both excellent for
strengthening the abdominal muscles and reducing an
excessive accumulation of fat in case of obesity of this
region.

Fig. 51. — Exercises for muscles of back.

Fig. 52.— Exercises for muscles of abdomen.

Fig. 53. — Swimming exercises: for back, thighs, and abdomen. First

position.

Fig. 54. — Swimming exercises: for back, thighs, and abdomen. Second

jx)sition.

Fig. 55. — Rope-pulling exercises: for back, chest, waist, legs, and
arms. First position.

Fig 56. — Rope-pulling exercises: for back, chest, waist, legs, and
arms. Second position.

Fig. 57. — Exercises in lateral trunk flexions: for shoulders, chest,
hips, and legs. First position.

SYMMETRIC DEVELOPMENT 351

Swimming Exercises: for Back, Thighs, and Abdo-
men (Figs. 53, 54). — First Position. — The movements
given here are those for the breast-stroke in swimming.
Stand with the feet about eighteen inches apart, with the
right foot advanced and the right leg straight ; the weight
is thrown on the left leg, and the arms bent at right angles,
ready for the beginning of the stroke, as shown in the pose

Second Position. — Shoot the arms directly forward,
incline the whole body forward, straighten the left leg, and
throw the weight on the right, which should be bent,
as shown in the second pose. Then sweep the hands and
arms outward in a horizontal plane, until the arms, trunk,
and legs are brought into the original position.

Then take the same exercises, reversing the positions of
the right and left legs.

In taking these exercises the arms, body, and legs must
work simultaneously. Special stress must be placed on
the alternate flexion and extension of the front and rear
leg and the inclination of the body forward with each
stroke.

While these exercises strengthen the muscles of the arms,
shoulders, and chest, they are especially intended for the
extensor muscles of the back and thighs and muscles of
the abdomen.

Rope-pulling Exercises: for Back, Chest, Waist,
Legs, and Arms (Figs. 55, 56).— First Position.— Stand
with the feet about eighteen inches apart, the arms ex-
tended out in front of the body and well out from the sides;
the right foot is advanced, and the weight rests mainly on
the right leg.

Second Position. — Clinch the hands tightly, as though
grasping a rope, and sway to the left side, at the same time
straightening the right leg; bend the left knee, and pull
the hands toward the waist, as though pulling the rope in ;
then extend the arms and return to the first position.

Repeat the exercise with the position of the legs re-
versed.

The arms must be extended well out from the sides,

352 PERSONAL HYGIENE FOR WOMEN

bending at the waist-line, so as to increase the reach, and
the swaying back and forth must be done with perfect
regularity.

This is a good all-around exercise, as it brings into play
and strengthens the adductors of the thighs, calves, and
extensors of the legs, the broad muscles of the back, the
muscles of the chest, waist, and the flexors and extensors
of the arms.

Exercises in Lateral Trunk Flexions : for Shoulders,
Chest, Hips, and Legs (Figs. 57, 58).— First Position. —
Stand with the feet eighteen inches apart, with the right
arm extended upward and the left downward, and the
weight of the body thrown on the right leg, while the left
leg is extended directly to the side.

Second Position. — Change the weight to the left leg,
and bend the left knee while the right leg is extended.
At the same time bring the right arm down and carry the
left up and sway the body at the hips to the right side.
The feet are kept flat on the floor during the entire exer-
cise, and it will be noticed that the arm, which is extended
downward, is on the same side as the extended leg.

These exercises increase the flexibility of the chest,
strengthen the muscles at the sides of the waist, and
cause some massage of the liver.

Exercises in Trunk Flexions : for Muscles of the
Back, Abdomen, and Leg (Figs. 59, 60). — First Position. —
Stand with the feet about six inches apart, the body bent
well forward at the waist-line, while the legs are rigidly
extended at the knees. Increase the bend gradually at
the waist until the tips of the fingers touch the floor be-
tween the feet, as shown in the pose.

Second Position. — From the first position carry the arms
directly forward, upward, and backward until they reach
the position shown in the second pose, with the knees and
ankles flexed; bend the trunk as far backward as possible,
while the arms are extended over the head. Maintain
for a moment, and return to the original position.

These movements must all be taken slowly, and in the

Fig. 58. — Exercises in lateral trunk flexions: for shoulders, chest,
hips, and legs. Second position.

f r
f

Fig. 59. — Exercises in trunk flexions: for back, abdomen, and legs
First position.

Fig. 60. — Kxercises in trunk flexions: for l>ack. abdomen, anil legs.
Second position.

Fig. 61. — Chest weight exercises for arms and shoulders. First

position.

Fig. P>2.— Chest weight exercises for arms and shoulders. Second

position.

Fig. 63. — Chest weight exercises for shoulders and chest expansion.
First position.

04. — Chest weight exercises for shoulders ami chest ex{mnsion.
Second position.

Fig. 65. — Chest weight exercises for extending depth of chest. First

position.

Fig. 66. — Chest weight exorcises for extending depth of chest.
Second position.

Fig. 67. — Chest weight exercises for chest expansion. First position.

Fig. 68. — Chest weight exercises for chest expansion. Second

position.

Fig. 69. — Figures of the dance. First position of the hands and feet.

SYMMETRIC DEVELOPMENT 353

beginning do not attempt to go far back of the vertical
line. Nearly all the muscles on the front and back of
the body are involved in these exercises, but the greatest
strain comes on the muscles of the back and abdomen and
the muscles on the back of the thighs. The bending and
rising bring into powerful action the extensors of the back
and neck and the retractors of the shoulders.

After this exercise has been mastered, it can be used to
still further expand the lungs, by forcible inspiration when
the chest is in the most favorable position for expansion;
retain the breath while the trunk is flexed, forcing the air
into the cells of the lungs under pressure. This last fea-
ture of the exercise should not be attempted by any one
with weak lungs.

Boxing and Fencing. — Boxing and fencing are both
excellent exercises for the lungs, for both sides of the body,
for balance, for rapidity, for endurance, variety, prompti-
tude, and sudden adaptation; for originality, up to a
certain point, as well as for self-reliance and fearlessness.
They have the advantage of cheapness, and are best prac-
tised in the open air.

Exercises with Chest Weights : for Chest Expan-
sion, Shoulders, and Arms. — These exercises are excel-
lent for developing the muscles of the upper part of the
chest, and for rounding out the chest, shoulders, and arms.
They are also good flesh-reducing exercises.

The weights should be fairly light at first, beginning
with perhaps two and one-half pounds, and gradually in-
creasing until five pounds are used. The weights should
only be increased with the increase of the strength of
the individual. All the movements should be performed
consecutively from ten to twenty times each; then pro-
ceed to the next movement.

In taking any heavy exercise great care must be used
not to overfatigue the muscles, or more harm than good will
be done. As soon as the muscles have become too tired
to perform any exercise vigorously, it should be discon-
tinued, and a rest of a few minutes taken, when the exer-

23

354 PERSONAL HYGIENE FOR WOMEN

cise may be resumed. When a point is reached at which
the muscles feel tired at the commencement of the exer-
cise stop at once for the day.

Chest Weight Exercises for Arms and Shoulders (Figs.
61, 62). — First Position. — Face the chest weights, grasp
the handles firmly, and hold the arms straight out in front
of the chest. Stand with the heels nearly together, and
far enough away from the weights to raise them a little
distance from the floor.

Second Position. — Draw the two handles to the chest and
almost under the arm-pits, letting the elbows and shoulders
go well back; then extend the arms. Repeat ten times.

Chest Weight Exercises for Shoulders and Chest
Expansion (Figs. 63, 64). — First Position. — Hold the arms
straight out in front.

Second Position. — Then, still keeping them in a horizon-
tal position, throw them back as far as possible.

Chest Weight Exercise for Extending Depth of
Chest (Figs. 65, 66).— First Position.— Stand with the
back to the chest weights, palms forward, arms straight.

Second Position. — Let the arms go past the sides, back
and up as far as possible; then bring them down and for-
ward and return to first position.

Chest Weight Exercise for Chest Expansion (Figs. 67,
68). — First Position. — Stand with the back to the chest
weights, holding the arms straight out in front.

Second Position. — Then, keeping them straight and in a
horizontal position, throw them back as far as possible.
With the arms still extended on a straight line with the
shoulders, bring them forward until the hands meet in
front. This is an excellent exercise to expand and develop
the chest.

Classic and Esthetic Dancing: an Essential
Feature in Physical Training. — From earliest antiquity
the dance has been of universal practice among all peoples
of the earth, both savage and civilized, and it has been
made to express all the emotions of which the mind is
capable of feeling. Dancing held a prominent position
among the gymnastic exercises of the Greeks.

SYMMETRIC DEVELOPMENT 355

The teachers of physical training have long felt that
even the combination of gymnastics and athletic sports
left much to be desired in the carriage and movements of
the body, so classic and esthetic dancing, which stands
between the two, more closely allied to gymnastics in its
movements and to games in its spirit, was introduced as
an additional gymnastic exercise, to harmonize the move-
ments of the body, and to produce an ease of manner with
a grace of beauty and of motion.

Society Dancing. — A sharp distinction must be made
between the modern gymnastic dancing and society danc-
ing. In the latter, the waltz and the two-step always
require a partner. The dancing is ordinarily confined to
the ball-room, with its poor ventilation and overheated
air; add to these the constriction of the waist, so that the
free action of the heart and lungs is interfered with, and
under these conditions it may even prove a dangerous
pastime to the young woman with weak heart or lungs.
As a physical exercise, the waxed floor of the ball-room
still further reduces its value.

Gymnasium or Classic and Esthetic Dancing. — For the
gymnasium dancing there must be, first of all, the loose
dress and heelless slippers, and an abundant supply of
fresh air at a proper temperature, while the foot grips
the floor as tenaciously as in boxing or fencing; a smooth
floor renders an artistic execution impossible. The floor
should be rough or covered with canvas, when dancing
becomes as good a developer of the heart and lungs as
running or swimming.

Girls in good physical condition can keep up esthetic
dancing for an hour with very few rests or pauses. The
work done in one hour is about equivalent to a walk of ten
miles.

The first steps in the attainment of grace of motion is
to avoid short, angular, jerky movements, and to learn
to do everything, even the most difficult exercises, with
the least expenditure of power and energy. This implies
considerable muscular strength and great muscular en-

356 PERSONAL HYGIENE FOR WOMEN

durance and control. As soon as the dancer loses her
balance or poise, holds one arm too straight, and bends the
other one at too sharp an angle, or puts too much stress
on this movement and too little on that, or makes too
much effort, the harmony is lost and gracefulness is not
attained.

The modern gymnasium dancing conforms more com-
pletely with the requirements of good exercise than ball-
room dancing, because the trunk, arms, and legs are brought
more generally into action. While the exercises of the
feet and calves are not so intense or so concentrated as in
ballet dancing, the range and the extent of the movement
are much greater. Not only are the shoulder, back, and
chest muscles considerably developed by the free use of the
arms, but so many of the muscles of the lower part of the
back, abdomen, and thighs are used that greater respira-
tory power is acquired to sustain the extended action;
hence, the chest-walls are expanded by the effort, and the
abandonment of the corset during dancing gives the utmost
freedom to all respiratory movements.

Statistics show that some of the benefits accruing from
a conscientious study and practice of aesthetic dancing are,
that it raises and develops the chest, lengthens the wajst,
and also reduces its circumference; the hips are reduced in
size, the thighs and calves are enlarged, while the ankles
are made smaller and the insteps are raised and given a
higher arch. Properly applied and directed, dancing ex-
ercises are even a cure for flat-foot.

The improvement noted in thirteen young ladies during
twenty-five days by M. B. Gilbert is as follows: The
average increase in the normal chest measure, from half
an inch to one and a half inches; with the chest inflated,
from half an inch to one and three-fourth inches.

The foundation for this coordinate work, from which
an unlimited variety of the most valuable developing
exercises is formed, consists of the long-established five
positions of the feet and five positions of the arms, to-
gether with positions of the whole body, known as atti-

Fig. 70. — Figures of the dance. Second jxxsition of hands; second
position of right foot.

Fig. 71. — Figures of the dance. Third position of hands; third
position of right foot.

l''ig. 72. — Figures of the dance. Third position ("amplified")
of hands: fourth position of right foot, in front. N. B. — When the
arm* are not in motion, the palms must be turned down.

Fig. 73.- — Figures of the dance. Fourth position of hands; fourth
position of right foot, in back.

Fig. 74. — Figures of the dance. Fifth position of hands; fifth
position of right foot.

Fig. 75.— Figures of the dance. Forward balance.

Fig. 76. — Figures of the dance. Itackwnni balance.

Fig. 77. — Courtesy.

Fig. 78.- Highland fling.

Fig. 79. — Hornpipe step "on heels," pulling down the small ropes.

Fig. 80. — Swedish step from " KulUlanyen."

Fig. 81.— Circles with hands, from Spanish dances.

Fig. 82. — Combination of dance steps. First position.

Fig. 83. — Combination of dance steps. Second position.

I' iff. 84.— Combination of dance steps. Third jxjsition.

Fig. 85. — On the toe tips.

SYMMETRIC DEVELOPMENT 357

tudes, arabesques, poses, elevations, groupings, etc. From
these precepts are established, whereby steps, attitudes,
and motions are systematically arranged, according to the
method, and in strict harmony with time and cadence of
music.

The freedom given by such dancing softens the crude
awkward positions so universal among young people; the
general carriage invariably improves as the head goes up
and the shoulders go back; a more elastic tread and an
easier propelling of the body in walking is gained. Not
only is the chest broadened and deepened, and fat removed
from waists and hips, and weak backs strengthened, but
students gain in quickness of perception, coordination, and
judgment, as well as in agility and power to keep their
feet in correct rhythm.

Esthetic dancing is particularly recommended in all
factories, stores, and schools where there are any large
number of girls and women as a recess exercise, because in
this way they get a great deal of vigorous exercise in a very
short time. It brings all the large muscle groups into
action, causes a rapid circulation of the blood, aerates the
lungs, and it affords the best possible sort of a contrast
to their monotonous and cramped positions; it is most
exhilarating and it is good fun. It is an excellent mental
tonic and physical invigorator; it brightens the day, and
enables the women to do better work.

FIGURES OF THE DANCE WITH SOME SIMPLE
EXERCISES

Fundamental Positions of the Hands and Feet (Fig.
69). — First Position of the Hands and Feet. — Stand erect,
resting on the balls of the feet, with the chin up and the
chest high; arms straight down almost touching the body;
hands about 6 inches apart, slightly curved, palm toward
palm; the thumb opposite the middle finger, elbows held
slightly away from the body as in the figure. Stand with
the heels together and the feet turned out so as to form a
right angle.

358 PERSONAL HYGIENE FOR WOMEN

Second Position of the Hands and Feet (Fig. 70). — Move
the hands and arms away from each other until the hands
are about 3 feet apart as in the figure. Move the right
foot directly to right in line with left foot and about 12
inches away from it; toe touching floor, instep well arched,
heel raised and kept turned toward left heel as in Fig. 70.
Counterpart for left.

Third Position (Fig. 71). — Bring the elbows up until
they and the hands are in line with the shoulders, finger-
tips almost touching across chest, palms toward the body
as in the figure. Move the right foot forward until the
right heel is in the hollow of the left foot and at right angle
to it as shown in the figure. Then move the right foot
back of the left until the hollow of the right foot is back of
the left heel. Notice that the feet should touch closely and
the legs be very straight. Counterpart for left foot.

Third Position of Hands Amplified (Fig. 72). — Extend
the hands to the sides in a straight line with the shoulders;
if this position is to be maintained turn the palms toward
the floor, with the thumb under the middle finger.

Fourth Position of the Right Foot in Front (Fig. 72). —
Move the right foot' directly forward about 12 inches in
front of the left foot, as in the figure, toe touching the
floor, heel raised; instep arched. Counterpart for left
foot.

Fourth Position of Hands (Fig. 73). — Move hands and
arms up until the hands are about 3 feet apart above the
head; palms toward each other, arms nearly straight as in
the figure.

Fourth Position of Right Foot in Back (Fig. 73). — Move
right foot about 12 inches back until in line with left foot,
toe touching floor, heel raised as in the figure. Counter-
part for left foot.

Fifth Position of Hands and Feet (Fig. 74). — Move hands
more closely together until about 6 inches apart; palms
toward each other and the arms very slightly bent as in
the figure.

The right toe touches the left heel in back, or right heel

SYMMETRIC DEVELOPMENT 359

touches left toe in front as in the figure. The feet are at
right angles. Counterpart for left foot.

Elevated Position of the Feet. — The second and fourth
positions may be elevated by extending the leg and foot at
right angles to the body. See Figs. 70, 72, 78, 82, 83, and
84. The third and fifth positions become elevated 'by rais-
ing the foot, toe pointed to the floor, as in combination of
steps, Figs. 78 and 82.

N. B. — In elevated positions the toe must be extended
so that the foot and leg form a straight line.

Simple Exercises Using the Fundamental Positions. —
Stand with feet in first position; hands in first position
(Fig. 69). — Exercise 1. — Move right foot to second position
(Fig. 70), and back to first position four times. Left foot
the same.

Exercise 2. — Move right foot from fourth position hi
front (Fig. 72) to fifth position in front (Fig. 74). Repeat
four times. Right foot in back (Fig. 73), fourth to fifth,
four times. Left foot in back, fourth to fifth, four times.

Exercise 3. — Move right foot from second position to
third in front, to second, to third in back. Repeat four
times. Left foot the same.

To make the exercise more difficult, hold the skirt ex-
tended with the hands in the second position (see Fig. 77).
Or arms extended in third position amplified, palms down,
which is very difficult.

Music in 6/8 time will add interest.

Ann Movements. — Exercise 4- — Move hands from first
position to second and back to first. Repeat four times.
N. B. — Draw the hands away from each other by the
wrists, and toward each other by the wrists. The hands
should move as though trailed through water.

Exercise 5. — Move the hands from the third position, to
the third position amplified, and back again to third (Figs.
71, 72). Repeat four times. N. B. — Move to third posi-
tion from first position. Do not go directly from the first
position to third position amplified, but through third
position in front.

360 PERSONAL HYGIENE FOR WOMEN

Exercise 6. — Move hands from fourth to fifth position,
four times.

Exercise 7. — Move right hand to fourth position, left
hand to second position, starting from third in front, back
to third position. Repeat four times. Change hands,
moving right to second, left to fourth position.

Use slow rhythmic waltz music for exercises 4 to 7.

Combination of Hand and Foot Movements. — Waltz
music at first and later 6/8 tune.

Forward Balance (Fig. 75). — Step forward on right foot,
left foot extended in fourth position back; right hand in
fourth position, left hand in second.

Backward Balance (Fig. 76). — Step back on the left foot,
raising the right foot in elevated third position in front;
right hand in third position in front of waist, left hand in
fifth position. Counterpart, starting with left foot.

Courtesy (Fig. 77). — Grasp the skirt lightly at either side
between the fingers, keeping the backs of the hands for-
ward; hands in second position. Point the right toe in
second position. Count, "One, Two." Lifting the heels,
turn on both toes until you face toward the left. Count,
"Three, Four."

Place the left foot in fourth position back of right foot,
bending both knees as if you were sitting down. Count,
"Five, Six." Slightly spread the skirt. N. B— Keep the
body erect from the waist up.

Rise to the standing position, drawing the right foot
backward into the first position. Count, "Seven, Eight."

Counterpart for Courtesy to the left. Music, Gavotte
or Schottische played slowly.

Highland Fling Step (Fig. 78). — Point right foot to sec-
ond position, right arm is bent at elbow and wrist, left arm
is almost in fifth position. Hop on left foot, at the same
time bringing right foot in very elevated fifth position
back of left knee. Hop on left foot bringing right foot in
front of knee; hop on left foot bringing right foot back of
knee again. Repeat to the left with hands in correspond-
ing positions. .

SYMMETRIC DEVELOPMENT 361

Hornpipe Step (Fig. 79). — Keeping feet in first position,
walk forward on the heels very quickly, taking steps of
about 1 inch in length. Look up and with the hands keep
pulling down an imaginary rope, moving one hand con-
stantly above the other.

Swedish Step from " KuUdansen" (Fig. 80).— Place right
heel in second position, arms in second position modified.
Bow to the right, bending at the waist. Repeat to the
left with the left heel in the second position, right foot in
first position. Repeat several times.

Spanish Cirde with Hands (Fig. 81). — Kneel on the left
knee. With both hands make circles going from left to
right, sweeping from third position at floor level to fifth
position and back again, four times.

Combination of Dance Steps — First Position (Fig. 82). —
Left foot in fifth position front. Swing the left foot in
circle to fifth position in back. Right hand holding skirt
in third position in front, left hand holding skirt in third
position amplified.

Second Position (Fig. 83). — As left foot arrives in back of
right, swing arms to third position amplified. Move the
left foot to second position.

Third Position (Fig. 84).— Move the left foot to the fifth
position in front, kicking the right foot in second position
elevated. Right hand in third position; left hand in third
position amplified.

Pose on Toe Tips (Fig. 85). — Rise on the tips of the toes,
the feet as close together as possible, bringing the hands
from the first to the fifth position.

When the pupil has mastered these very skilfully ar-
ranged series of dancing poses, steps, and exercises she
has learned how to dance; that is, she is in a position, after
watching any new dance for a short time, to go on the
floor with a leader.

Women in the prime of life will be interested to know that

in twenty lessons of one-half hour each, given at the

Women's University Club under the able instruction of

Miss Rabinovitz,1 to a class of women ranging in age from

1 Superintendent of Dancing, New York Public Schools.

362 PERSONAL HYGIENE FOR WOMEN

thirty to fifty years, two-thirds of whom had either never
learned to dance or who had not danced since childhood,
not only learned the above various dancing steps and
exercisers, but also the following dances.

The Folk Dances were: The Tantouli (Swedish); Ace of
Diamonds (Danish); Reap the Flax (Swedish); and the
Sailor's Hornpipe (English). This last dance was es-
pecially for the very excellent exercise which it afforded.
The Minuet was taught for form, grace of movement, and
exercise. There were also taught the Hesitation Waltz,
the Maxixe, and the Lulu Fado.

Outdoor Exercise. — Outdoor exercise must be regarded
as one of the essentials to good health, and as such must
be classed with food, clothing, bathing, and sleep.

In addition to the beneficial effects of exercise on the
muscles, circulation, and all the functions of the body, are
the soothing effects of outdoor life on the nerves. It is
only out-of-doors, in the parks, in the country, or by the
sea that one is soothed into entire oblivion and forgetful-
ness of the cares of life, and to such a degree that the in-
dividual may be said to be hypnotized by the powers of
nature, so that the mind is almost as perfectly at rest as in
a sound sleep.

The time spent out-of-doors should not be less' than
two hours daily. Actual experience of busy workers will
prove that not only is this time not lost, but that actually
more and better work can be done in the day, and that the
resulting improvement in the general health will be so
great that much less time will be lost through indisposition
and actual sickness, so that the daily outdoor exercise
will be found to be a great economic gain.

Outdoor exercises, such as walking, running, swimming,
and hill and mountain climbing, possess the very great
advantage that indulging in them demands no expense,
and are, therefore, open to all. All these exercises de-
velop the lungs and chest and strengthen the heart, and
are, therefore, classed under exercises of endurance.

The Effect of Walking on the Heart and Lungs. —

SYMMETRIC DEVELOPMENT 363

In a slow walk the respiratory action is almost double the
ordinary amount; in walking at an ordinary pace, that is,
about three miles an hour, it is four times as great; while
in a vigorous or hasty walk, that is, at a rate of from four
to six miles an hour, it is from seven to nine times as
great.

The change of speed from three to five miles an hour
elevates an automatic, listless occupation into a vigorous
exercise, employing many new muscle groups and stimu-
lating the heart, lungs, and skin, while the change from a
smooth, level road to the broken ground of the mountain-
side may be dangerous for many a one who is able to walk
at a moderate speed on level ground.

In walking the clothing must be sufficiently loose not to
interfere with the more rapid respirations and the increased
action of the heart. When the heart cannot keep pace
with the demanded speed of the circulation, a "stitch"
ensues, and getting one's second wind means that the heart
has succeeded in accommodating itself to the strain. Too
great a "stitch," resulting in absolute breathlessness,
is a warning that must not be disregarded.

This increase in the respiratory action is important,
as compared with the brief and transient increase from
exercise with apparatus, because a quick walk can easily
be kept up for several hours.

The fatigue is small, because, in the first place, of the
abundant supply of oxygen; the will is scarcely used, and
walking is almost automatic, partly because the muscle
areas used are large, and each movement prepares for the
next. Walking is a heart and lung exercise of a very ex-
cellent sort.

The Effect of Walking on the Movements of the Blood in
the Legs. — The circulation of the blood depends on the
pumping of the heart, which is in turn affected by the suc-
tion action of the lungs and the muscular movements of
contraction and relaxation which go on rhythmically.
While in prolonged standing the veins of the legs become
fuller, and the circulation of blood in them more sluggish,

364 PERSONAL HYGIENE FOR WOMEN

and by the laws of gravitation the blood is kept down in
them. Hence also in walking slowly with short steps the
legs remain overfull of blood and become heavy. Instead
of being quickened, the circulation is actually hindered,
for the waste-products are not carried away quickly enough.
Hence, slow walking soon causes a feeling of fatigue, while
the vigorous walker, going along with long strides, keeps
fresh.

Rules for Long Walks. — In walking, not only the dis-
tance should be taken into account, but the character of
the road and the incline of the ascent. A distance that
could be easily covered on a smooth, level highway may
mean double the expenditure of muscle and nerve force if
the ground is sandy or very damp. Other hindrances to
be taken into consideration are opposing winds, not only
because of the resistance, but also because of the inhala-
tion of dust and rain.

The walk should be occasionally broken for short periods
of rest. The pauses should be short, about five minutes,
and during this time the body should be erect. Experi-
ence proves that sitting down makes one more tired on
getting up again. A short halt should be made before
climbing a steep ascent, so as to begin with fresh strength
and easy breathing, as this means increased work for the
heart and lungs.

In starting out for a walk, one should begin slowly, and
gradually increase the pace, and in returning the same rule
should be observed.

Running. — The force exerted in running is enormous.
In running it is the length of the step more than anything
else which increases the speed of the run; hence, the runner
should learn to take long steps. But the greatest speed
can only be kept up for a limited time; the distance is one
hundred yards.

Running is the most effective of all exercises of speed,
and, like all exercises of speed, can be changed into one of
endurance by a certain moderation in the pace. By

SYMMETRIC DEVELOPMENT 365

running the heart and lungs are developed more than by
any other exercise.

Age Limit for Running. — All ages are not equally well
adapted for running: they do not all share in its good
results. Running is best for all young people, before and
at the age of puberty. Running is then quite a necessity.
The growing child is always ready for a run. From the
fortieth year on running, as an exercise of speed, becomes
less and less desirable, and, when the organs of circula-
tion or breathing are impaired, it must be absolutely
forbidden.

In running always begin slowly — running moderately,
for instance, for fifty feet ; then increase the speed gradually,
but when running for exercise, never speed to the utmost, as
this is not necessary for the benefits of the exercise.
Always close the run with the same moderation with which
it was commenced ; that is, never stop short, as this sudden
arrest of action gives a most undesirable shock to the heart.
The movements of running may easily be imitated hi the
house, while standing in one piace, and simply lifting the
feet in the same quick alternation from the floor.

Mountain Climbing. — The advantages of mountain
climbing are manifold. The weight of the body has to be
carried up a certain height. To accomplish this the work
of the muscles is increased; the breathing must be deeper
to satisfy the increased demands for oxygen; fresh air is
admitted into the apices of the lungs, which do not, as a
rule, participate in respiration. A more powerful action
of the heart takes place, but care must be taken that this
is not carried too far. Slow climbing, without any un-
necessary waste of energy and with appropriate pauses,
to allow the heart to recover, is advantageous. One
should not talk too much while climbing. The dress
should be suitable ; the neck must be free and the shoulders
not heavily weighted, so that they may be drawn back
and the chest fully expanded.

Swimming. — Of aU outdoor exercises for women,
swimming is one of the most perfect. It not only calls

366 PERSONAL HYGIENE FOR WOMEN

into vigorous action most of the muscles of the body, but
spares many of those muscles which are so commonly
overworked, most of the work being performed by muscles
which are so little used as to have become weak and
flabby.

For instance, the extensors of the fingers and the hand,
that are so constantly stretched in sewing and writing,
are in constant use in swimming, while the corresponding
flexors, the slaves of the needle and the pen, are relaxed.
Again, the muscles passing from the shoulder-blades to
the trunk, on which depends much of the erect carriage
and strength of the chest, which have become wasted from
disuse while the woman sat at the desk or bent over her
sewing, are the very muscles by which the movements
of the upper half of the body are executed, while all the
muscles of the lower extremity are brought into use.
Of especial value is the free movement of the hip-joint, a
joint that is seldom moved with any degree of freedom
from the time a girl leaves climbing trees, unless she has
the advantage of special gymnastic training. The vigor-
ous action demanded of the respiratory muscles greatly
increases the chest capacity.

The body is lighter than the water, and is perfectly
supported by it, so the weight is taken off the spine, and
the muscles of the back are relieved from their normal
state of tension. The head is the only part of the body
that is held up by muscular action, and, in floating, even
this is supported by the water.

The disadvantages arise from the fact that the tempera-
ture of the water is very much below that of the body,
so that there is a greatly increased conduction of heat from
the body, and, unless this loss is made good by exercise,
there is very great danger of a chill. In most persons a
prolonged stay in cool or cold water produces a liability
to cramp.

During the month of August the temperature of the
ocean reaches its maximum of 66.65° F. This is about
32 degrees below the temperature of the body. Upon

SYMMETRIC DEVELOPMENT 367

entering the water the first effect noticed is a sensation of
cold ; this varies with the susceptibility of the individual,
and the difference between the temperature of the water
and the surrounding air. The skin assumes the appear-
ance of "goose-flesh," the face is pale and anxious, and
the lips are blue; the pulse decreases in frequency, a sense
of oppression is manifest, and there may be spasmodic
shivering; that is, the first effect of immersion is to cause
a contraction of the blood-vessels of the surface of the
body. This should be quickly followed by a secondary
reaction, in which there is a sensation of warmth, a quick-
ened pulse, and an increase of energy. When, by taking
the proper precautions, this reaction does not occur, it is a
contraindication to sea-bathing and swimming.

If the immersion has been too prolonged, there is a
second sensation of chilliness, a signal that the bather
must leave the water at once.

The best time for bathing is between eleven o'clock in
the morning and four in the afternoon, depending on the
tide. No one should go into the water within two hours
after meals, nor should she on leaving the bath proceed
at once to the table, since digestion draws the blood from
the periphery to the stomach, and to eat immediately
after bathing is to lose most of the benefit of the saline
treatment.

All should avoid cold-water bathing when fatigued,
and swimmers ought to pay especial attention to this point,
on account of the demand they are going to make on their
muscular system; and on no account must one enter the
water when in a perspiration; a moderate walk along the
shore should be taken until the perspiration has subsided.
These precautions are of the highest importance, and dis-
regard of them may prove fatal.

Enter the water quickly until it reaches the waist, then
plunge headlong, or cover the body to the neck. Care
should be taken to wet the chest and abdomen immedi-
ately on entering the water, since these parts are the most
sensitive to the impression of cold.

368 PERSONAL HYGIENE FOR WOMEN

Every one should learn to swim, and those who cannot
must move the arms and legs about vigorously. The
duration of the bath should depend on the state of the
health of the individual, on the state of the weather, and
on whether the water is rough or calm. The average dura-
tion of the time spent in the water should be from three to
fifteen minutes, the latter being the maximum time for
any one. No benefit will accrue from spending a longer
time than this in the water, and much harm may result.

The sea-bath should be followed by moderate exercise,
in order to insure a perfect reaction, and to aid in expend-
ing the superfluous energy which sea-water imparts.

Swimming and sea-bathing should be avoided by per-
sons who have weak hearts and a poor circulation, in
whom the reaction after a plunge into cold water is never
well established. Also by persons with heart or kidney
disease, and by all feeble and old persons.

Persons with feeble constitutions, but with no actual
disease, as in various forms of nervous disorders, insomnia,
etc., generally derive marked benefit from sea-bathing.

Persons who are weak should walk and not plunge into
the water. As in all other exercises, a determination on the
part of the weak to equal the strong is a fertile cause of
mischief.

Horseback Riding as an Exercise. — The advantages
claimed for horseback riding are that it acts on nearly
every muscle of the body, while the mind is interested and
refreshed. An insuperable disadvantage to the majority
of women living in large towns and cities is the enormous
cost of the exercise.

The value of horseback riding for women has been greatly
diminished by the very faulty position caused by the side-
saddle, which produced a cramped position of the body and
a tendency to lateral curvature of the spine. Then, too,
women ride too tightly corsetted, thereby preventing much
good that would otherwise accrue to the circulation and
digestive organs.

When the woman rides astride, the body is held erect

SYMMETRIC DEVELOPMENT 369

and in a natural position, and she sits much more
firmly on her horse and, if not corsetted, it becomes an
exhilarating and delightful form of exercise. The best
results will probably be found in a neurasthenic class of
women, who are not strong enough to take more active
exercise, and for them it will be of decided therapeutic
value to both mind and body.

Rowing. — This is one of the most beneficial of exercises;
it has the advantages of scenery, freedom from dust, and
companionship; it exercises equally both sides of the body
and most of the muscles. It is an excellent exercise for
strength, rapidity, and endurance.

In correct and graceful rowing there is a pendulum-like
movement from the hips. The rower should sit with
the trunk fully extended, the head up, the eyes to the front,
the chest thrown forward, and the weight of the trunk
equally distributed upon the two sides of her seat. The
feet rest against the stretcher, the two hands should be
near together, and should be held symmetrically at an
equal distance from the body.

Stretching. — The body and extended arms are brought
forward as far as possible. The spinal column should be
kept extended, not bent so as to make a crooked back,
and the trunk should be thrown forward from the hip-
joints. When the stretch has reached its forward limit,
the oar is dipped into the water just far enough to cover it;
then immediately the pull begins, and it must be continued
evenly to the end.

The Pull. — The body rises erect from the hips and
swings backward. The hands should not reach the front
of the chest until the body has passed the perpendicular
and is sinking back. When the pull is finished, the hands
are dropped and suddenly bent toward the wrists. This
lifts the oar out of the water, and keeps its lower surface
parallel with it; during the stretching forward, the oar
is kept parallel with the water, so that it has not much
resistance from the air.

The muscles brought chiefly into play are the long
24

370 PERSONAL HYGIENE FOR WOMEN

muscles of the back in the backward swing, and the ab-
dominal muscles in the forward swing. But the muscles
of the pelvis, thighs, and legs all have to work, likewise the
muscles of the arms, chest, and shoulders. And it is one
of the best exercises for developing the lungs and chest, as
well as of strengthening the heart. Fatigue will be felt
most in the muscles of the legs, hips, and arms, but the
exertion is so well distributed that it causes much less
fatigue than would otherwise be the case.

Athletic Sports. — Athletic sports possess three distinct
advantages — they are played out-of-doors, and give an
incentive to taking the proper amount of exercise; they are
all team games, and so develop the social and cooperative
spirit; and last, but by no means least, they afford a great
deal of amusement and real recreation.

Formal and systematic gymnastics are essential for the
development of the body and the correction of its defects;
out-of-door exercise is excellent, but the solitary walk,
climb, swim, or row leaves much to be desired, while in
walking especially the mind is free to pursue the same
trains of thought which with it was occupied at the desk,
and so it fails to be properly refreshing to the mind and
body. Whereas in all athletic sports the ego has to be
pushed into the background, with all its interests; the
day's work left behind, and the entire attention concen-
trated on the play. This is a very distinct advantage to
the individual.

Women at all ages take themselves and life too seriously.
This is in all probability due to a defective early education;
between the long school hours, home study, housework,
and sewing, they had neither time nor opportunity to cul-
tivate a love for play and games, and so the play instinct
was not developed, and if not developed in youth, the
chances are that it never will be. In middle and advanced
age, when the stress and storm are at their height, nothing
is so sure a restorative to overtaxed brains and over-
wrought nerves as games, sports, and a love of fun.

As a result of our unnatural mode of life in youth, it has

SYMMETRIC DEVELOPMENT 371

come to pass that American women especially have been
defrauded out of their birthright of the love of games and
sports. Athletic games and sports are as essential to a
scheme of education as are reading, writing, and arith-
metic.

Other distinct advantages accruing to athletic games
are that here the individual becomes acquainted with her
powers and weaknesses. In formal gymnastics the move-
ments follow each other in a regular sequence, through
lines already carefully laid out; in games, on the contrary,
no two plays or combination of plays are exactly alike.
One can never tell what her opponent is going to do, and
yet what one's opponent does is so vital to the success or
failure of the game that the player must decide quickly
and accurately how that move in the game can best be
met, so that intense concentration, quickness, alertness,
prolonged attention, self-control, and even self-sacrifice
are called for, for in the team game the individual inter-
ests must be submerged, in order that the side may win;
and so the individual power, sense of responsibility, and
an esprit de corps are developed, in a manner almost im-
possible in the same degree in any other way.

The principal outdoor games for women are croquet,
lawn-tennis, hockey, golf, hand-ball, basket-ball, baseball,
boxing, and fencing.

Croquet. — Of all these games, croquet is the mildest,
and for that reason is a good beginning game for a woman
who has always led a sedentary life, or for a woman who
has become enfeebled through serious illness. It is also
an excellent game for old age.

To be beneficial and not detrimental, the exercise must
be very gradually increased, both in the length of time oc-
cupied and in the vigor of the movements. The muscles
must be slowly built up and improved in tone, the lungs
developed, and the heart strengthened.

Another advantage of croquet is that it is inexpensive
and requires a limited amount of ground.

Lawn-tennis. — Tennis is a much more violent exercise

372 PERSONAL HYGIENE FOR WOMEN

than croquet, and is a game for young people and youth.
Now, as to just what constitutes youth: it is altogether a
question of the condition of the arteries, heart, and mus-
cular system, and is not a question of years per se.

The game is moderately expensive; played with four,
it is not at all violent. It is an excellent game for social
purposes, and can be kept up until late in life, but it cannot
be begun late in life. It has just the proper amount of
variety, activity, and endurance to suit hundreds of
people for whom croquet would be too mild, and for whom
ball-games would be too severe.

Golf. — Golf is deservedly a very popular game at all
ages. Perhaps the greatest drawback for the city dweller
is the inaccessibility of the golf links and the great expense
of the game.

It combines scenery, walking for several miles, some hill
climbing, and a considerable amount of exercise for the
right side of the body, particularly for the right arm, and
the muscles of the right side of the back and chest. The
great drawback, from the physical standpoint, is an over-
development of the muscles of the right side of the body,
which, in the majority of people, are already better devel-
oped than those of the left side ; the muscles of the left side
of the body are brought very slightly into play.

While the distinct advantages of the game are combined
with walking, the healthy body swings, the accuracy
needed in making the drives, the distance of the drives, the
variety of implements as well as of stroke, and many other
features, and, further, it is a game that keeps one pleasantly
employed in a company of one's choosing for several
hours.

Hockey. — Hockey is among the finest of games for
most young people, and should rank at least third among
games. It has most of the advantages of foot-ball, and
many of the advantages of cricket. It involves a consider-
able amount of running and a great deal of real sport and
fun.

SYMMETRIC DEVELOPMENT 373

Basket-ball. — This is another of the most popular
games for young people, and possesses in a very great
degree all the advantages of a team game. The confi-
dence that follows a successful throw proves of considerable
value, unless it leads to the carelessness of overconfidence.
Faith in the ability to get out of a desperate situation in
the tossing increases with success. This leaves the atten-
tion imperturbed, and one does not go to pieces. Ac-
cording to Mosso, movements develop the brain, and it has
been repeatedly noticed that intelligence in animals in-
creases with the increased motility of their extremities.

INDEX

ABDOMEN, protuberant, 344
causes of, 344
treatment, 45, 52, 298, 344
Abdominal exercises, 344, 346,

348

muscles, 344
development of, 344, 346,

348

flabby, 147
function of, 146, 344
Ablutions, 33, 34
cold, 34
hot, 33
Acne, 65-67
causes of, 65
treatment, 66

Air, amount breathed daily, 145
"bouquet" of, 149
chemical properties of, 149
country, 149
degree of moisture for house,

155, 156

impurities in, causes of, 152
cumulative effects of, 152,

153

injurious effects of, 153
indoor, 151
infection of, 150
overheated, injurious effects of,

155

pure, test of, 153
town, 149

Air, vitiation of, from combustion

of lights, 152
from respiration, 152
from unhygienic conditions,

152

Alcohol, 127-135
absorption of, 129
anemia from use of, 131
as a food, 127, 128
cumulative effects of, 128
narcotic effects of, 128
physiologic action of, 127-130
obesity caused by, 132
on blood, 130
on brain activity, 134, 135
on digestion, 129
on heart and blood-vessels,

132

on kidneys, 133
on liver, 130

on metabolism. 129

on muscular system, 133
on nervous system, 127,

134, 193
on oxidation, interference

with, 131

on self-control, 135
rub, directions for, 35
Alcoholic beverages, amount of

alcohol in, 128
Alimentary canal, 80

microorganisms of, 220
375

376

INDEX

Ambition, excessive, 234, 244
American men, improved phys-
ique of, 287

women, inferior physique of, 284
Amino-acids, 94, 105
Ammonia, aromatic spirits of,

dose of, 218
Amylase, 94
Amylopsin, 94
Anabolism, 99
Anemia, causes of, 153
Anger, injurious effects of, 245
Animal food, 110
Anxiety, injurious effects of, 246
Arteries, description of, 139
effect of cold on caliber of, 29,

30, 140
of muscular work on caliber

of, 139

Astigmatic chart, 208
Astigmatism, correction of, 208
injurious effects of unconnected,

208, 343
test for, 208
Athletic games and sports, 318,

322, 370-373
advantages derived from,

318, 370-373

and municipal govern-
ments, 318
basket-ball, 373
benefits of, 319, 320
best suited for women,

321, 322
croquet, 371

ethical value of, 318-321
hockey, 372
lawn-tennis, 371
Attitude, correct, at desk, 165

in standing, 340
faulty, injurious effects of, 164,
342, 343

Auto-infection, 170
Auto-intoxication, 102
Autosuggestion, 244
Avocation, 198-200

nature of, 198

physiologic necessity for, 200

BACK, muscles of, 301, 302

exercises for, 345, 346, 350,
351

function of, 301, 302
Bacteria, action of sunlight on,

151

intestinal, 97
r61e played by, 150
Bacterial flora, 159, 220
Baldness, causes of, 72
treatment for, 72-74
Basket-ball, 373

Baths, action of, in health, 23, 58
alkaline, 37
cold, 29-33

contraindications to, 31, 37

heat loss in, 30

physiologic effects of, 29

reaction after, 30, 31

tonic effect of, 29, 32, 33

training for, 59, 60
dip, 36

contraindications to, 37

duration of, 36

temperature of, 36
effects of, 23
electric-light, 44-46

directions for, 44, 46

indications for its use, 45, 222
foot, 39

directions for, 39

indications for, 39

mustard, 183
friction after, 31
hot, 28, 29

INDKX

377

Baths, hot, effects of, 28

reaction after, 29

restorative effects of, 29
neutral, effects of, 29, 33

temperature of, 29
proper time for, 59
Roman, 43
Russian, 42

contraindications for, 43

indications for, 43
saline, 37

as cleansing agent, 38
salt ablution, 41

indications for its use, 41
method of taking, 41
shower, or rain douche, 38, 39

cold, 38, 39

directions for, 38

effects of, 39

hot, 38

indications for, 39

neutral, 38

temperature of, 38
sit/. 40

duration of, 40

indications for, 41

temperature, 40
sponge, 33, 34
tub, 34, 36

full, 36
contraindications to, 36

half, 35

temperature of cold, 36

of hot, 36

of neutral, 36
Turkish, 42-48

contraindications for use of,
44

essential features of estab-
lishment, 42

indications for its use, 44

loss of weight from, 46

Baths, Turkish, method of pro-
cedure, 42, 43
necessity for cold water

drinking, 42
varieties of, 33

Bathtub hose, fallacy in use of, 39
Bedrooms, ventilation of, 156
Bile, action of, 92
Bladder, 179
capacity of, 179
frequency of emptying, 179
location of, 179
Blood, 142

corpuscles of, 130, 142
distribution of, 142
functions of, 26, 130, 142
length of time for passage

through body, 141
thinness of. See Anemia.
vascular areas of, 27, 29
Body, balance and carriage of,

308, 322, 355
common defects in, 309
fatigue of, 193
position of, 164, 165
Boracic acid, solution of, 214
Boxing, 353
Brain and nervous system, 184-

188

blood supply, during sleep, 193
development, of 189, 228-230,

233, 241, 295, 320
fatigue of, 185

effect of body fatigue on,

194, 221, 316, 317
functions of, 184
habit and automatism, 186
master organ of body, 184
physiology of, 187
repair of, 185, 186
rest of, 193, 197
workers, average of life of, 233

378

INDEX

Brains vigorous and strong bod-
ies, 290, 292

Breathing, art of, 167
difficult, treatment of, 167
exercises. See Respiratory.
normal, 166
types of, 167

Bromid mixture, prescription for,
218

Bronchial tubes, 143

Bronchitis, cause of, 150
chronic, cure of, through exer-
cise, 168, 169

CAPILLARIES, 139
Carbohydrates, absorption of, in

intestines, 95
as protein protector, 100
physiologically economic, 107
Carriage, good, exercises for, 348,

354

Cataract, 215
Character, formation of, 231, 238,

241

influenced by example, 228, 238
mental poise, 234
power of will, 242
Cheese, indigestibility of, 112
Chest, description of, 138
development of, 344, 356, 362
exercises for, 346, 349, 351,

353, 354

importance of good, 147
flat, causes of, 165, 261, 265,

309
corrective exercises for, 165-

168

measurements minimum under
arm, consistent with good
health, 147

relation between height,
weight, and, 148

Chest weights, exercises with, 353,

354

for arms, 354
for chest expansion, 354
for shoulders, 354 .
rules for taking, 353
Chilliness, cause of, 146
Chlorids, 101
Chyme, 90

Circulation, maintenance of equi-
librium, 143
mechanics of, 138-142
Circulatory apparatus, 139

system, 137

Clothing, measurements for, 164
suspension of, from shoulders,

164, 282
Clouston, necessity for definite

occupation, 248
Clubs, literary, 199

women's, benefits of, 199
Clysters, colo-, 53

directions for, 53, 54
Cold, effects of prolonged appli-
cation of, 30
physiologic effects of, 29-32,

139, 140

reaction following, 30, 31
condition unfavorable to, 31
how promoted, 30, 31
injurious effects following

poor, 32

tonic effects of, 32, 33
Colds, causes of, 151, 153, 156
common, 170
contagiousness of, 163
frequency of, 170
reinfection from 170
relation of, to influenza, 169
to pneumonia, 169
to tuberculosis 169
treatment of, 145, 170, 171

INDEX

379

Colds, treatment of, prescription

for, 171
quinin in, 171
College life, advantages of, 232,

233

discipline of, 233
Vassar, 235
woman's medical, 235
Coloclysters, directions for, 53, 54
Colon, 96

Color blindness, 215
Complexion, 57, 58
care of, 61-63
good, 57, 58
sallow, 64

Conjunctivitis, causes of, 213
granular. See Trachoma.
symptoms of, 214
treatment of, 214
acute, 214
chronic, 214
Constipation 102,
causes of, 103, 104, 344
chronic, 104
injurious effects of, 220
appendicitis, 102
autointoxication, 102
hemorrhoids, 102
uterine displacements,

102

treatment, 52-54, 103
Corns, treatment, 79

varieties, 78
Corsets, 255, 256, 275
abdominal, 269, 270
crusade against, 259
curved front, 261, 262
directions for adjusting, 274
effect on lung capacity, 201,

262

on muscles, 264-268
on thorax, 260

Corsets, history of, 257-259
hygienic, 269
influence on female body, 260-

270

injurious effects of, 260-269
relation to abdominal and pel-
vic disorders, 262-264
straight front, 268, 269
tight lacing and, 260, 261, 274
wearing by young girls, 270-

272
what style is least injurious,

272-274

Cosmetics for the face, 63, 64
Cough, function of, 169
Country folks, outings by, 200

recreations for, 199
Cramp ton, Dr., and school ath-
letics, 287
Croquet, 371

DANCE, arm movements, 359

combination hand and foot
movements, 360

figures of, with simple exer-
cises, 357

fundamental positions of hands
and feet, 357

simple exercises, using funda-
mental positions, 359
Dancing, 289, 326

aim of, 354

benefits of, 354-357

esthetic and classic, 354-357

requisites for, 354

society, 355
Dandruff, 70-72

causes of, 70

contagiousness of, 71
Deafness, causes of, 163

prevention of, 103
Debility, signs of, 216

380

INDEX

Desk, correct attitude at, 165
Development, necessity for good,

298, 311, 314
symmetric, 292, 315
Diaphragm, 141, 142, 144, 261
relative importance of, 144,

147, 262

Diet, balanced ration, 115
finical, 172
importance of fats in, 107, 112

of varied, 116

in sedentary occupation, 113
in tropics, 121
maintenance, 109
practical facts for guidance, 115
regulation of, with reference to

minimum expenditure, 122
relation to various conditions,

112

brain workers, 113
children, 113
muscular work, 113
sex, 113

temperament, 113
tuberculosis, 172
Dietaries, balanced ration, 115
in health, 66
in tropics, 121

practical facts for guidance, 115
standard, 109
Dietetics, defined, 109
Digestion, defined, 80
controlling factors in, 83
mechanical, 87
psychic aspect, 85

tone, 87
gastric, 89

absorption of food, 92
chemical changes, in, 98
mechanics of, 90
intestinal, 92

absorption of food, 94

Digestion, intestinal, bacteria, 97

mechanics of, 96
Digestive fluids, 92-94
bile, action of, 92
gastric juice, 89
intestinal juice, 92
pancreatic, 93
saliva, 88

succus entericus, 94
system, 80
tract, 80

Discipline, 228, 229, 232
Disinfectants, carbolic acid, 175
formaldehyd, 174, 175
sulphur, 174
Disinfection after tuberculosis,

directions for, 174, 175
Douche, 46-48
application of, mass, 47
pressure, 47
temperature, 47
cold, contraindications to, 48
long applications, 47, 48
mechanical effects of, 47
physician's prescription for,

48

physiologic effects of, 48
fan, 47

horizontal jet, 47
neutral, indications for, 48
rain, 38, 39

directions for, 38
effects of pressure in, 39
rationale of, 47
Scotch, 47
temperature and its effects,

47

neutral, 48
Dress and woman's physical

deterioration, 252-282
corsets, 257-275
gymnastic, 336

INDEX

381

Dress, history of woman's, 252-

259

French, 255-259
Greek, 252-254
medieval, 254-256
renaissance, 256, 257
Roman, 253, 254
shoes, 275-277
street, winter, 282
Drudgery, joyless, 198
Dust, its relation to disease, 149

EAR, 162

ache, treatment of, 164
description of, 162
douching, 56
wax, 163

removal of, 163
Eczema, 65
chronic, 65
seborrheic, 71

causes of, 72

symptoms of, 71

treatment, 73, 74
Education and the health of

girls, 234
college, 232

discipline, 232, 233, 320
effect on home, 237

on physical health, 234, 236
higher, of women, 234-237
President Eliot on, 235-

237

mental development, 228-232,
320

faculties, balancing of, 234

habits, 186, 187
moral sense, 230, 231
physical, influence on health,

310-316, 324
religious instincts, 231
self-control, 229

Education, truthfulness, 228, 229
Eggs, digestibility of, 110
nutritive value of, 110
Electric-light baths, 44, 46

comparison of, with other

heat procedures, 44
description of cabinet, 44
indications for use of, 45
length of stay in, 44
reduction of weight through,

46
symptoms of too prolonged

stay in, 46

treatment, finishing, 45
Eliot, President, on higher edu-
cation of women, 235-237
Emotional nature, 230, 231
Emotions, depressing, 246

physical effects of, 246
the natural, 226, 227, 230, 231
violent, 243

Employees, care of, 324, 324, 357
Enemas, 53, 54

injurious effect of daily, 54
Energy, 99

Environment, 237-240
friends, 238

harm done by bad, 238, 239
literature, 239, 240
toilet, 237, 238
Enzymes, action of, 84

defined, 84
Erepsin, 94
Eustachian tube, 162
Exercise after eating, 316
after fasting, 335
and amusement, 357, 370
benefits, of, 311 312, 313, 323-

325

effects of, on brain develop-
ment, 291
on character, 291, 320

382

INDEX

Exercise, effects of, on heart and

lungs, 295, 310
on muscles and blood-ves-
sels, 293, 294, 295, 312
gradual training in, 312
heart's need of, 310
increase of red blood-cells

through, 294

length of time for, 334, 362
outdoor, horseback riding, 328,

368

mountain climbing, 365
rowing, 369, 370
running, 341, 364
swimming, 365-368
walking, 362-364
passive. See Massage.
physiology and pathology of,

292, 311, 312

regularity in, 288, 335, 362
rules for taking, 334-336
Exercises, corrective, abdominal,

346, 348, 350, 352
alternate kneeling, 348
arms, 351, 353, 354
balancing, 349
back, for muscles of. 346,

350-352
carriage, 348
chest, 351-354
for developing various re-
gions of the body, 341-
354

for extending depth of, 349
forward projection of, 346
hips, 352

legs, 347, 351, 352
poise, 348
respiratory, 345
rope pulling, 351
shoulder-blade, 345, 346
spine, 347

Exercises, corrective, squatting,

347
standing, correct attitude in,

340

swimming, 351
thighs, 351
trunk flexions, 352

lateral, 349, 352
waist, 349, 351
exhaustion, recovery from, 293,

294

free, rules for taking, 343
of endurance, 292, 293, 295
of strength and skill, 292,

293, 295
Exhaustion, injurious results of,

193, 194, 197, 221
recovery from 294
symptoms of, 194-196
Eyes, 204-211
care of, 212
healthy, 209
injuries to, 213
interruption of work of, 209,

210

protection of, 211
removal of foreign bodies from,
213. See Visual apparatus.
Eyestrain, 204

general symptoms of, 209
local symptoms of, 209
mechanism of, 209
prevention of, 210

FACE as index of health, 57
cleansing of, 61
dryness of skin of, 62
lotions, 62
massage of, 67
powders, 63, 64
protection of, 63
steaming, 67

INDEX

383

Face, use of cosmetics, 63

of soap, 62
Facial blemishes, 65-67

eczema, 65
causes of, 65
general treatment, 66

freckles, 64

liver spots, 64

pimples and acne, 65
causes of, 65
treatment of, 66

sallow complexion, 64
treatment, 66

wrinkles, 67-69
Far-sightedness, 207
Fat, 107, 112

as protector of protein, 100
Fatigue, undue, 294

causes of, 199, 303, 304

danger signal, 193

economic waste of, 194

effect of brain, on body fatigue,
316, 317

effect of, on nerve cells, 192

mental symptoms of, 192

muscular, 303, 304

normal, 192

recovery from, 294

toxins of, 190-192, 203

treatment, 222, 305
Fear, 227

forms of, 227

physical effects of, 227, 244

universality of, 227
Feet, care, of, 78

corns, treatment of, 79

ingrowing nails, 78

perspiration of, 78

protection of, 276, 277
Female form, relative proportion
of, 296

generative organs, 179

Female generative organs, Fal-
lopian tubes, 179
function of, 179
ovaries, 179
physiology of, 179
uterus, 180
functions of, 180
respiratory movements

of, 180
Fencing, 353

Food, absorption of, from in-
testines, 94
from stomach, 92
amount required, 104
animal, 110
breads, defective method of

preparation, 120
carbohydrates, 107
physiologically economical,

107

potatoes, 111
rice, 111
wheat flour, 111
chemical changes in, in stom-
ach, 89

classification of, 105
digestibility of 110
beef, 110
buttermilk, 111
chicken, 110
eggs, 110
koumiss, 111
milk, 111
mutton, 110
pork, 110
economics, 122

relation to social welfare, 114
fat, 107, 112
heat value and digestibility,

ll<>

indigestible combinations, 119
influence of, on secretion, 98

384

INDEX

Food, iron, 102

mineral substances, 107

preparation of, 119

proteins, 105, 115
foods rich in, 115

values, 124-127

variety of, 116

vitamins, 108

Food-stuffs, carbohydrates, 107
as protein protectors, 100

classification of, 105

daily amount required, 66

fats, 107, 112
as protein protectors, 100

mineral substances, 107

proteins, 105
as source of energy, 105

salt, 101

water, 100
Foot, configuration of, 337, 338

description of, in walking, 338-

340

Freckles, 64
Friction, mechanical effects of,

31,306
Friends, choice of, 238

molding effects of, 238, 239

requirements for, 239

GACHES-SARRAUTE, Madame, hy-
gienic corsets, 269

Games as supplement to gym-
nastics. See Athletic games
and sports.

Gastric juice, 89

Golf, 372

Greek costumes, 252-254

Gymnasium in campaign against

disease, 323-325
Vassar College, 325

Gymnasiums, 336, 337

Gymnasiums against disease, 312,

313, 323-325

and factories, 324, 325, 357
and women's colleges, 325
Gymnastic dress, 336
Gymnastics, benefits from, 314-

316
for symmetric development,

315

medical, 314
physical examination for, 326,

327

practice of, 314
versus athletics, 313

HABIT and automatism, 186
Habits and disease, 244

age limit for, 186, 187

bad, 186
Hair, 70-76
' brushing, 73

care of, 72-74

cutting of, 74

dandruff, 70

description of, 70, 71 >

dressing, 74

gray, 75
causes of, 75
treatment of, 75

premature thinness of, 70
treatment of, 72, 73

scalp, dry, treatment of, 74
massage of, 74

seborrhic eczema, 71

shampoo, 73

treatment of, 73
Hair-brush, 73, 74

care of, 74
Hancock, Dr., physical training

for women, 286
Hands, care of, 76, 77

chapped, 76

INDEX

385

Hands, nails, care of, 76
cleansing of, 77
infection from lack of clean-
liness, 77
Headache, 216-219

causes of, 209, 216, 217, 221

symptoms of, 217

treatment of, 217-219

varieties of, 217
neuralgic, 217
Health, good, and vacations, 201,

202

evidences of, 215
Hearing, impairment of, causes

of, 163
Heart, description of, 139

frequency of beat, 140

functions of, 139

location of, 139
Heart's need of exercise, 310
Heat, animal, 26

dissipation of, 26

physiologic effects of, 27

production of, 26, 27, 303, 308
Height, weight, and chest meas-
urements, relative proportion

of, 148, 297
Hemorrhoids, 102
Hereditary predispositions, 225
Heredity, influence of, on health,

224-226
Hockey, 372
Hormones, 89
Horseback riding, 328
Hot-water bottle, action of, 29
Houses, degree of moisture of air
of, 155

disinfection of, after tubercu-
losis, 174, 175

effects of gloomy, 238

temperature of, 155

ventilation of, 151-155

Hydrotherapy defined, 23
value of, 23. See Baths and

Douches.

Hygiene of mind, 224-251
Hygrometer, 156

IDLENESS as cause of nervous

prostration, 223, 247
Thomas on ill effects of, 248,

249
Industrial training of women,

necessity for, 247
Infectious diseases, 169-175

bronchitis, 159, 160, 168, 169
causes of, 149-151, 153, 169
common colds, 159, 169-171
influenza, 159, 169, 170
pharyngitis, 151, 159, 160
Influenza, 169
cause of, 150, 159
relation of, to pneumonia, 171

to tuberculosis, 169, 173
Ingrowing toe-nails, causes of, 78

treatment of, 78
Inhibition, 240-242
importance of, 242
training in, 241
Insomnia, 196
causes of, 194, 196, 220
injurious effects of, 203, 219
treatment of, 39, 204
Intestinal bacteria, 97
Invertase, 94
Iron, 102
Irrigations, vaginal, 54-56

KATABOLISM, 99

Kidneys, description of, 175

diseases of, treatment of, 52

function of, 175-179

386

INDEX

Kidneys, function of, relation of,

to skin and lungs, 176
Knee-chest position, description

of, 53

LACTASE, 94

Lamp shades, 211, 212

Larynx, 143

Laughter, physiologic necessity

for, 200, 201

Life, prolongation of, 132, 313
Lighting, artificial, 211, 212

natural, 212
Lipase, 94
Literature, 239, 240

molding influence on the mind,
239

taste for, formed in youth, 240
Lungs, 143

description of, 143

frequency of diseases of, 137

good development of, 137, 311
exercises for, 165-168, 345,
349, 353

hygiene of, clothes in relation
to, 164

relation of, to good health, 146

secretion of, 145

ventilation of, 165-168

vital capacity of, 148

weakness of, causes of, 137

MALTASE, 94
Massage defined, 304
benefits of, 304-306
mode of procedure, 307
movements of, 306

friction, 306

grasping and pinching, 306

striking, 307

stroking, 307

vibration, 307

Massage, rise of temperature

after, 308

tune for giving, 307
Mastication, 82, 88
Meats, digestibility of, 110
nutritive properties, 110
Medical examination blank, 330
Menstruation, 181-183
anomalies of, 183
painful, 183
profuse, 183
scanty, 183
suppressed, 183

treatment of, 182, 183
hygiene of, 181
normal, average duration of,

181

character of, 181
cold baths during, 181, 182
exercise during, 182
premonitory symptoms of, 181
Mental activity, attitude and

bodily function of, 242
depression, 231
development, 189, 190, 228-

232, 233,241
and physical training, 290-

292, 295, 315, 320
disorders of adolescence, 231
emotions, exhausting nature of,

245-247

faculties, balance of, 234
habits, 186, 187
hygiene, 224-247

hurry, effect of, 190
qualities, 228
Metabolism, 98
cumulative effects of impure

air on, 153
effect of nitrogenous diet on,

99
water and, 100

INDEX

387

Microorganisms in intestinal

canal, 97

Migraine, treatment of, 218
Milk, digestion of, 111
Mind hygiene, relation of, to
physical health, 224-251, 320
subconscious, 238
Mineral substances, 107

Vittel, 51

Moral sense, 230, 231
Mothers as educators, 224

exhausted, 197
Mountain climbing, 365
Mouth, care of, 82
cleansing of, 82
Muscular system, 298-304

action of muscles of abdo-
men, 300
of back, 301
coordination, 304
development prevented by cor-
sets, 200, 261, 264-268, 270,
271

energy, 303
fatigue, 303
heat production, 303

NASAL catarrh, causes of, 159

general treatment, 151

local, 160, 161

prevention of, 160
douche, 161

passages, obstruction of, 158
sprays, 160

prescriptions for, 161
Nature's restoratives, 196-200

recreation, 198, 200

rest, 197

sleep, 198, 202, 203
Near-sightedness, causes of, 206,

207
correction of, 207

Nervous breakdowns, prevention

of, 197, 199, 201
disorders, causes of, 216
functional, 215, 223
headache, 216-219
neurasthenia, 219
system as balance of power,

184
brain as master organ of

body, 184
function of, 184
physiology of, 187
cerebrospinal nerves, 187
spinal cord, 187
sympathetic, 188
Nervousness, 196
causes of, 196
treatment of, 305
Neurasthenia, 219-223
causes of, 219, 220
rational treatment, 221-223,

305

symptoms of, 221
Nitrogenous waste products, 106
Nose, care of, 157
functions of, 157

OBESITY, causes of, 132, 298

treatment of, 45, 52, 298, 344
Occupation, definite, a physical

necessity, 247

Clouston on, 248. See Voca-
tion.

sedentary, 165

Optical defects and their correc-
tion, 206-209
astigmatism, 208
hyperopia or far-sightedness,

207
myopia or near-sightedness,

206
causes of, 207, 209

388

INDEX

Optical defects, myopia, treat-
ment of, 207

presbyopia or loss of ac-
commodation, 207
Out-door exercise, 362

daily length of time for, 362
Overwork, 193, 194
danger signals, 193
signs of, 194-196
stimulants in, 193
worry and, 195
Overworked class, rest treatment

for, 222, 223
Oxygen, importance of, 145

PALATE, soft, 158
Pancreatic juice, 93

rennin, 93

Perspiration, daily amount of, 26
effect of, on tone of skin, 29
rate of increase in hot baths,

28

Pharynx. See Throat.
Physical efficiency, 11
an exact science, 13
marks for, 13, 317
reflex effect of group impair-
ment on organism, 19
standardized percentage

table, 14, 328
statistical study, 15
wisdom of, 11
exercise, rules for, 334-336
measurements, record for, 327,

334

status of women of today, 19
training among the ancients,

283, 284, 289
before twelve years of age,

333

dancing, 289, 326
examinations for, 326, 327

Physical training for invalids, 334
improved physique from,

286, 325
influence on life and health,

290
key to health and beauty,

283-322

of girls, 286, 289, 321, 333
of Japanese women, 286
report of Royal Commission

on, 288
Physique, good, through physical

training, 333
improved, of American women,

287

of school children, 287
Play, adult, 288
Pleasure seeking as the object

of life, 189, 247, 249
Pneumonia following influenza,

169

mortality from, 171
Potatoes, 111
Prosecretin, 92
Proteins, 105
Pulley weights, exercises with.

See Chest weights.
Pulse, frequency of, 140

READING, distance of book from

eyes, 165
fine type, 212

hygienic precautions, 212, 213
length of line, 212
position of reader in, 212

Recreation, necessity for, 220

Religion, 232

Religious instincts, 231, 232

Rennin, pancreatic, 93

Respiration during sleep, 166
forced, benefits of, 165, 166
impediments to normal, 164

INDEX

3SU

Respiration, mechanics of, 138,

141
normal, relation to body heat,

146

types of, 167
costal, 167
diaphragmatic, 167
thoracic, 167
vitiation of air in, 152
Respiratory exercises, 165-168,

345

beneficial results of, 311
best time for, 166, 167
dress for, 166

frequency of, practice of, 166
system, 137-157
air cells, 143
bronchial tubes, 144
expiration, 143
inspiration, 143
forced, 144
function of abdominal

muscles, 146, 344
larynx, 143
lungs, 143
hygiene of, and relation to

general health, 146
secretion of, 145
vital capacity of, 144
thorax, 138
trachea, 143
Rest, 197

days of, 200, 201
proper way to, 197, 198
regularity of, 197
Rice, 111
Roman baths, 43
Rowing, 369
Running, 293, 364
age limit for, 365
benefits of, 310
rules for, 341

SALIVA, 88
Salt, common, 101
normal, solution, 53
sea, 41
Sargent, Dr. Dudley A., 284, 285,

287, 317, 321
Scalp, massage of, 74
Sebaceous glands, function of, 25

infection through, 25
Secretin, 92
Self-control, 229, 230
difficulty of, 229
standards aimed at, 229
training in, 230
Semiconstipation, 102
Senility, causes of, 133
Sewing, hygienic precautions in,

212, 213
Shoe, 275-277

compression of foot by, 275
flat heels, 276
French heels, 277

awkward gait due to, 277,

339

deformities caused by, 277
injurious effects of, 277
proper length of, 276
soles of, 276

Shoulder-blade exercises, 345
Shoulders, round,* and inequality

of height of, 342
causes of, 342
corrective exercises for, 345,

346.

Sims' position described, 53
Skin, absorption through, 28
care of, 57-69
description of, 24, 25
diseases, acne, 65
eczema, 65
treatment of, 66
functions of, 25

390

INDEX

Skin, functions of, respiration

through, 28
role played in maintaining

body temperature, 26
sebaceous glands, 25
sweat glands, 25

perspiration, daily amount

of, 26

temperature of, 31
tone of, 25

Skirt, walking, 202-204
Sleep, 202-204
amount necessary, 196, 203
dreamless, 204
favorable conditions for, 204
habits of, 198, 203
physiologic necessity .for, 185,

192, 193, 203
Sleepiness, causes of, 203
Soap, 58
castile, 61
sand, 61

tincture of green, 73
Social instincts, 226
at school age, 226
right training of, 241
Sore throat, prevention of, 160

treatment of, 160, 161
Spinal cord center of reflex acts,

187
curvature, 309

causes of, 164, 342, 343
general treatment for, 343
Spine, muscles of, exercises for

strengthening, 347
Spirometer, 148
Sponge as article of toilet, 33
Spray apparatus, description of,

160

liquids for, 161
oil, formula for, 161
Standing, common defects in, 340

Standing, correct attitude in, 340
Steapsin, 94

Stocking supporters, 278
Stockings, evils of short, 277
Stomach, chemical changes in
food in, 89

description of, 89

location of, 89
Street dress, winter, 282
Styes, treatment of, 215
Success defined, 249

elements of, 249

lack of, 250

mental condition and, 250

psychology of, 249-251
Succus entericus, 94
Sugar, absorption of, in in-
testines, 95
Sunlight, action on respiration,

149

on tubercle bacillus, 151
Swimming, 365-368

contraindications to, 368

exercises, 351

pool, temperature of, 326

rules for, 366-368
Swift, Prof., theories regarding

children, 228, 233
fighting among boys,
233

TEA, effect of, on digestion, 119

proper way to make, 120
Teeth, 82

care of, 82, 83

cleansing of, 83

tartar, 83

tooth-brush, 83
Temperament, 225, 226

arthritic, 226

nervous, 225

temptations of, 226

INDEX

391

Temperament, phlegmatic, 226
Temperature for house, 155
normal body, 27, 28
how maintained, 28
mouth, 28
rectum, 28
surface, 31

Thomas, Prof., on effect of idle-
ness, 248

on necessity of definite vo-
cation, 249

Throat or pharynx, 137
bacterial flora in, 151
description of, 158
diseases of, causes of, 158
effect of lowered vitality on,

151

importance of healthy condi-
tion of, 151, 159
pillars of, 158
sore, prevention of, 160
treatment of, 160, 161
Toe-nails, ingrowing, 78
Tonsils, chronic enlargement of,

159

Trachea, 143
Trachoma, 214, 215
Tropics, dietary in, 121
Trypsin, 93
Tubercle bacillus, 150

destruction of, 174
Tuberculosis, causes of, 137, 150,

309

diet in, 172

disinfection after, 174, 175
expectoration in, 150, 173
infection in, 150, 173

source of, 173
mortality in, 137
prevention of, 171-174
Turkish baths, 42-44
cold plunge, 43

Turkish baths, cold plunge, con-
traindications to, 31, 37

contraindications for their
use, 44

essential features of estab-
lishment, 42

harmful results of too pro-
longed stay in, 42

indications for their use, 44

methods of procedure, 42-44

necessity for cold water
drinking, 42

physician's prescription for,
43

shampoo, 43

steam room, 43

contraindications for
use of, 43

UNDERCLOTHING, combination

suits, 280
winter, 278-281

equestrian tights, 280
essential qualities of, 278
Urea, 106
Uric acid, 106

treatment of, 45

Urinary excretory apparatus, 179
Urine, 178

daily amount of, 178
secretion of, 176
specific gravity of, 178
toxicity of, 178, 179
urea, 178
uric acid, 178
value of study of, 178
Uvola, relaxation of, 158

VACATIONS and health, 201, 202
resorts, requisites for, 202
rules for, 202

Vaginal irrigations, 54-56

392

INDEX

Vaginal irrigations, directions

for, 54, 55

indications for use of, 55
Vassar College, 235

gymnasium, 325-328
Veils, 210

Ventilation, 151-155
method of, 154
necessity for indoor, 151

hourly amount of fresh air

needed, 151
of bedclothes, 157
of bedrooms, 156
of houses, 151-155
of lungs, 165-168
Vision, defective. See Optical

defects.
Visual apparatus, 205, 206

accommodation, mechanism

of, 206

conjunctiva, 205
description of, 205
eyeball, 205
eyelashes, 205
eyelids, 205

image, formation of, 206
iris, 205

function of, 206
lachrymal glands, 205
tears, function of, 205
Vitamins, 108
Vocation, physiologic necessity

for, 247

Clouston on, 248
Thomas on, 248, 249

WAIST exercises, 349, 351, 356
Walk, listless, bad effects of, 364
Walking, clothing for, 282, 363
effect of speed in, 293
on blood-vessels and mus-
cles, 363

Walking, effect of, on heart and

lungs, 362

position of feet in, 341
skirt, 281

proper length of, 281
Walks, rules for long, 364
Wash cloths, care of, 61

danger of infection from,

61

Waste products, nitrogenous, 106
Water and metabolism, 100
internal use of, 48-52

action on digestion, 50

on heart and blood, 50
at meals, 50, 51
boiled, 49

classification of tempera-
ture of, 28
cold, contraindications to,

52

infection, vehicle for, 49
mineral, 118 «

physiologic effects of, 28
therapeutic indications

for, 50-52

tune required for its ab-
sorption, 50
Weichardt, Dr., experiments on

guinea-pigs, 191

Weights for women, table of,
relation between height and,
296, 297
Weisse, Dr., table of weights, etc.,

296, 297

Will, education of, 241-245
influence of, on conduct, 241,

242

inhibition, 240-242
obsessions, overcoming of, 241
power of, and strong muscles,

291, 292
training of, 241

INDEX

393

Women, American, cause of in-
ferior physique of, 284-286
average height of, 298
higher education of, 234-237
in business activities, 237,

248

Japanese, 286

non-occupation of, 248, 249
noted sovereigns as mothers,

247

physical status, 19
Woolen undergarments, 279, 280

Work, hygiene of, 188

number of hours allotted to,
194

philosophy of, 188

physiologic necessity for, 189
Worry, 195, 196

denned, 245

results of, 246
Wrinkles, 67-69

causes of, 67, 68

results of, 68, 69
Writing, use of typewriter, 165

Books for Nurses

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Morse's Bacteriology for Nurses JUST READY

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nurses, very valuable being the work of Miss Jennie Manly.

Diseases of Children for Nurses. By ROBERT S. McCOMBS, M. D..
Instructor of Nurses at the Children's Hospital of Philadelphia, izrno
of 509 pages. Illustrated. Cloth. $2.25 net. Published June. 1916

Wilson's Obstetric Nursing NEW (*» EDITION

In Dr. Wilson's work the entire subject is covered from the
beginning of pregnancy, its course, signs, labor, its actual
accomplishment, the puerperium and care of the infant.
American Journal of Obstetrics says: " Every page empasizes
the nurse's relation to the case."

A Reference Handbook of Obstetric Nursing. By W. REYNOLDS
WILSON, M. D., Visiting Physician to the Philadelphia I,yiiig-iii
Charity. 258 pages, illus. Flexible leather. $1.50 net. April, 1916

American Pocket Dictionary NEW ocm.) EDITION

The Trained Nurse and Hospital Review says: "We have
had many occasions to refer to this dictionary, and in every
Instance we have found the desired information."

American Pocket Medical Dictionary. Edited by W. A. NEWMAN
DORLAND, A. M., M. D. Flexible leather, gold edges, $1.25 net ;
indexed, $1.50 net. Published September, 1917

THIRD
EDITION

Lewis' Anatomy and Physiology

Nurses Journal of Pacific Coast says "it is not in any sense
rudimentary, but comprehensive in its treatment of the sub-
jects." The low price makes this book particularly attractive.

Anatomy and Physiology for Nurses. By I,EROY I/:wis, M.D. 12mo
of 326 pages: 150 illustrations. Cloth, $1.75 net

Published September. 1913

Goodnow's War Nursing

Written at the front and on the battlefield, this book shows the
inexperienced nurse how to care for a ward of wounded men
from arrival to dismissal; it introduces you to actual conditions,
and shows you how they are best met.

War Nursing: a Text-Book for Auxiliary Nurses. By MINNIE GOOD-
NOW, R. N., War Nurse in France. 172 pages, illustrated. Cloth.
$1.50 net. Published December, 1917

Warnshuis' Surgical Nursing

The author gives you here the essential principles of surgical
nursing, and reliable fundamental knowledge based on his
own personal conclusions and experiences. Secondary matter
is excluded, and all primary and pertinent points are set down
briefly and concisely.

Octavo of 277 pages, with 255 illustrations. By FREDERICK C.
WARNSHUIS, M.D., F.A.C.S., Visiting Surgeon, Butterworth Hos-
pital, Grand Rapids, Michigan. Cloth, $2.50 net.

Published March, 1918

Friedenwald and Ruhrah's Dietetics for

NEW <4th) EDITION
This work has been prepared to meet the needs of the nurse,
both in training school and after graduation. American Jour-
nal of Nursing says it "is exactly the book for which nurses
and others have long and vainly sought."

Dietetics for Nurses. By JULIUS FRIEDENWALD, M. D., and JOHN
RUHRAH, M.D., University of Maryland School of Medicine and
College of Physicians and Surgeons, Baltimore. 12mo volume of 4€7
pages. Cloth, $1.50 net. Published July, 1917

FIFTH
EDITION

Friedenwald & Ruhrah on Diet

This work is a fuller treatment of the subject of diet, pre-
sented along the same lines as the smaller work. Everything
concerning diets, their preparation and use, coloric values,
rectal feeding, etc., is here given in the light of the most re-
cent researches. Published March, 1919

Diet in Health and Disease. By JULIUS FRIEDENWALD, M.D., and

JOHN RUHRAH, M.D. Octavo volume of 919

Catlin's Hospital Social Service

Miss Catlin's book is especially planned to help those who are
establishing social service centres in new fields, as well as
those in dispensaries already firmly established. She has had
the practical experience of many years to draw upon.

NELIA.CATLIN. R. N.. Director of Social Service Work. Youngstown
Hospital. Ohio. 12rao of 113 pages, with 43 illustrations. Cloth.
$1.25 net. Published May, 1918

Galbraith's Personal Hygiene and Physical
Training for Women NEW <2<n EDITION

Dr. Galbraith's book tells you how to train the physical pow-
ers to their highest degree of efficiency by means of fresh air,
tonic baths, proper food and clothing, gymnastic and outdoor
exercise. There are chapters on the skin, hair, development
of the form, carriage, dancing, walking, running, swimming,
rowing, and other outdoor sports.

Personal Hygiene and Physical Training for Women. By ANNA M.
GALBRAITH, M.D., Fellow New York Academy of Medicine. 12*10 of
393 pages. Illustrated. Cloth. $2.25 net. Published January. 1917

Galbraith's Four Epochs of Woman's Life

This book covers each epoch fully, in a clean, instructive way,
taking up puberty, menstruation, marriage, sexual instinct,
sterility, pregnancy, confinement, nursing, the menopause.

The Four Epochs of Women's Life. By ANNA M. GALBRAITH, M.D.,
with an Introductory Note by JOHN H. MUSSER, M. D. 12mo of 296
pages. Cloth, $1.50 net Third Edition published March, 1917

Griffith's Care of the Baby NEw «*

Here is a book that tells in simple, straightforward language
exactly how to care for the baby in health and disease ; how
to keep it well and strong; and should it fall sick, how to
carry out the physician's instructions and nurse it back to
health again. Published June. i9is

The Care of the Baby. By J. P. CROZER GRIFFITH, M.D.. Univers-
ity of Pennsylvania. lamo of 458 pages. Illustrated. Cloth, Si. 50 net

Aikens' Ethics for Nurses

This book emphasizes the importance of ethical training. It
is a most excellent text-book, particularly well adapted for
classroom work. The illustrations and practical problems
used in the book are drawn from life.

Studies in Ethics for Nurses. By CHARLOTTE A. AIKENS, formerly

, Superintendent of Columbia Hospital, Pittsburg. izrno of 320 pages.

Cloth, $2.00 net. Published April. 1916

Goodnow's History of Nursing

Miss Goodnow's work gives the main facts of nursing history
from the beginning to the present time. It is suited for class-
room work or postgraduate reading. Sufficient details and
personalities have been added to give color and interest, and
to present a picture of the times described.

History of Nursing. By MINNIE GOODNOW, R.N., formerly Super-
intendent of the Women's Hospital, Denver. izmo of 370 pages,
illustrated. Cloth, $2.00 net. Published December, 1916

Berry's Orthopedics for Nurses

The object of Dr. Berry's book is to supply the nurse with a
work that discusses clearly and simply the diagnosis, prog-
nosis and treatment of the more common and important' ortho-
pedic deformities. Many illustrations are included. The
work is very practical.

Or:hopedic Surgery for Nurses. By JOHN McWiLLlAMS BERRY.
M.D., Clinical Professor of Orthopedics and Rontgenology, Albany
Medical College. Cloth, $1.00 net. Published July. 1916

Whiting's Bandaging

This new work takes up each bandage in detail, telling you —
and showing you by original illustrations — just how each
bandage should be applied, each turn made. Dr. Whiting's
teaching experience has enabled him to devise means for over-
coming common errors in applying bandages.

Bandaging. By A. D. WHITING, M.D., Instructor in Surgery at the
University of Pennsylvania. i2mo of 151 pages, with 117 Illustra-
tions. Cloth, $1.50 net. Published November, 1915

10

Smith's Operating-Room

The object is to show you how to assist the surgeon according
to the newest operative technic. You get the result of active
experience systematized, and in concise form. You get a thor-
ough digest of every essential; detailed lists of instruments;
glossary of medical terms. Every phase of the subject is
covered by ample, practical instruction.

The Operating-Room. A Primer for Nurses. By AMY ARMOUR
SMITH, R.N., formerly Superintendent of Nurses at the Woman's
Hospital of the State of New York. 12mo of 295 pages, illustrated.
Cloth. $1.50 net. Published October. 1916

Handler's The Expectant Mother

This is an anatomy, physiology and hygiene covering those
points and functions concerned in child-bearing and designed
for the use of the nurse and the mother. Every question of
interest to the expectant mother is treated.

The Expectant Mother. , By S. WYLLIS BANDLER, M. D., Professor

• of Diseases of Women, New York Post-Graduate Medical School

and Hospital. Cloth, $1.25 net. Published October. 1916

Winslow's Prevention of Disease

Here you get a practical guide, giving you briefly the means
to avoid the various diseases described. The chapters on diet,
exercise, tea, coffee, alcohol, prevention of cancer, etc., are of
special interest. There are, besides, chapters on the preven-
tion of malaria, colds, constipation, obesity, nervous disorders
and tuberculosis. It is a record of twenty-five years' active
practice.

By KENELM WINSLOW, M.D., formerly Assistant Professor of Com-
perative Therapeutics, Harvard University. 12mo of 348 pages,
illustrated. Cloth, $1.75 net. Published November. I9l{

Brady's Personal Health

This is different from other health books. It is written by a
physician with some fifteen years' experience in writing for the
laity. It covers the entire range of health questions — care of
mouth and teeth, catching cold, adenoids and tonsils, eye and
ear, ventilation, skin, hair and nails, nutrition, nervous ail-
ments, etc.

Personal Health. A Doctor Book for Discriminating People. By

WILLIAM BRADY, M.D.. Klmira, N.Y. 12mo of 400 pages.

Cloth. $1.50 net. Published September. 1916

11

Hoxie's Medicine for Nurses

Medicine for Nurses and Housemothers. By GEORGE
HOWARD HOXIE, M.D. , University of Kansas. 12mo
of 390 pages, illustrated. Cloth, $1.75 net.

Third Edition— February, 1918

Bohm & Painter's Massage

Massage. By MAX BOHM, M.D., Berlin, Germany. Ed-
ited by CITAS. F. PAINTER, M.D. , Tufts College. Octavo
of 91 pages, 97 illustrations. Cloth, $1.75 net. June, 1913

Boyd's State Registration for Nurses

State Registration for Nurses. By LOUIE CROFT BOYD,
R. N., Graduate Colorado Training School for Nurses.
Cloth, $1.25 net. Second Edition— February, 1915

Morrow's Immediate Care of Injured

Immediate Care of the Injured. By ALBERT S. MOR-
ROW, M.D., New York Polyclinic. Octavo of 354 pages,
with 242 illustrations. Cloth, $2.75 net.

Third Edition— November, 1917

deNancrede's Anatomy EIGHTH EDITION

Essentials of Anatomy. By CHARGES B. G. DENAN-
CRKDE, M. D., University of Michigan. 12mo of 400
pages, 180 illustrations. Cloth, $1.50 net. Oct., 1911

Montgomery's Care of Surgical Patients

Care of Patients Undergoing Gynecologic and Abdom-
inal Procedures (BEFORE, DURING, AND AFTER OPERA-
TION). By E. E. MONTGOMERY, A.M., M.D., LL.D.,
F.A.C.S. , Professor of Gynecology in Jefferson Medical
College, Philadelphia. 12mo of 149 pages, illustrated.
Cloth, $1.25 net. Published December, 1916

Register's Fever Nursing

A Text-Book on Practical Fever Nursing. By EDWARD C.
REGISTER, M.D. , North Carolina Medical College. Oc-
tavo of 350 pages, illustrated. Cloth, $2.50 net* June 1907

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